Please complete the form below. You will be redirected to PayPal to submit your tuition payment and application fee. If you do not complete your payment, your application will not be sent.

1. I understand that I will have eighteen (18) calendar months to complete the Deaconry Training Progam. If I have not completed the course at the end of this period, I will be dropped from the course with no refund of fees paid.
2. I understand that I must be in communication with my mentor at least twice per month as a condition of continued enrollment.
3. I understand that I may terminate my participation in this course by written communication to my mentor.

PRIVACY NOTICE AND CONFIDENTIALITY: All personal information will be held in strictest confidence and will not be released outside of the Sacred Well Congregation without your expressed written consent. Demographic information will be used for administrative and statistical purposes only and will not be released outside the Congregation in any form that would identify you as an individual.

Items marked with an asterisk (*) are required.

First Name*

Middle Initial

Last Name*

Street Address*

Street Address 2

City*

State*

Zip*

Country

Email*

Telephone*

Birth Date*

Education:

Highest Degree Attained* ---High School DiplomaAssociate DegreeBachelor's DegreeMaster's DegreeDoctorate DegreeProfessional Degree

Name of Institution that awarded degree/diploma*

Year awarded*

Area of study*

Military Affiliation*?
YesNo

If you answered "yes," above, please answer the following:

Branch ---ArmyAir ForceNavyMarinesCoast Guard

Status ---Active DutyReserveNational GuardVeteranRetiredDependentContractor/Government Employee

Rank/Grade
---EnlistedOfficerGeneral Schedule ---123456789101112131415

Position

Are you interested in starting a group or being a DRGL in a military group?
YesNo

Autobiographical*: The summary should include significant details of personal history,your motivation for making this application,and any other information you believe to be relevant to this process

Type of Application*
---Individual $200Group $50

Please complete the form below. You will be redirected to PayPal to submit your tuition payment. If you do not complete your payment, your application will not be sent.

1. I understand that I will have eighteen (18) calendar months to complete the Neophyte Training Course. If I have not completed the course at the end of this period, I will be dropped from the course with no refund of fees paid.
2. I understand that I must be in communication with my mentor at least twice per month as a condition of continued enrollment.
3. I understand that I may terminate my participation in this course by written communication to my mentor.

PRIVACY NOTICE AND CONFIDENTIALITY: All personal information will be held in strictest confidence and will not be released outside of the Sacred Well Congregation without your expressed written consent. Demographic information will be used for administrative and statistical purposes only and will not be released outside the Congregation in any form that would identify you as an individual.

Items marked with an asterisk (*) are required.

First Name*

Middle Initial

Last Name*

Street Address*

Street Address 2

City*

State*

Zip*

Country

Telephone

Email*

URL

Name of Roedi/DTP Mentor

Comments

Please complete the form below. You will be redirected to PayPal to submit your tuition payment. If you do not complete your payment, your application will not be sent.

1. I understand that I will have eighteen (18) calendar months to complete the Roedi Training Course. If I have not completed the course at the end of this period, I will be dropped from the course with no refund of fees paid.
2. I understand that I must be in communication with my mentor at least twice per month as a condition of continued enrollment.
3. I understand that I may terminate my participation in this course by written communication to my mentor.

PRIVACY NOTICE AND CONFIDENTIALITY: All personal information will be held in strictest confidence and will not be released outside of the Sacred Well Congregation without your expressed written consent. Demographic information will be used for administrative and statistical purposes only and will not be released outside the Congregation in any form that would identify you as an individual.

Items marked with an asterisk (*) are required.

First Name*

Middle Initial

Last Name*

Street Address*

Street Address 2

City*

State*

Zip*

Country

Telephone

Email*

URL

Type of Application*
---Individual $150Couple $175Group (5-10) $75Group (10+) $50

Comments