PLTS Certificate in Church Leadership Application

The information on this form is used for public/directory information and academic databases. The information is intended for internal institutional use and will not be shared publicly except where noted.

Program Information

Program

Desired Start Date

Are you applying as part of a group or other cohort/program?

Yes

No

Please share the name of the group you are applying with:

This program offers the three options: to enroll in one course, enroll in three courses for the Basic Certificate, or enroll in six courses for the Advanced Certificate. Please select the option you plan on pursuing.

Enrollment

6-Course Advanced Certificate

3-Course Basic Certificate

1 Course Only (Can add additional courses in the future)

Contact Information

First Name

Preferred Name

Last Name

Pronouns

Mailing Address

Country

Street

City

Region

Postal Code

Cell Phone #

Please send me important messages via text message (standard message charges will apply).

Yes

No

Other Phone #

Email Address

Personal Information

Gender

Ethnicity

Birthdate

Country of Origin

Highest Level of Education Completed

Denomination Information

Religious Denomination or Affiliation

ELCA Synod

Synodically Authorized Ministry status (if applicable)

Personal Statements

Why are you interested in pursuing studies in Church Leadership? (300 words max)

What background, experiences, and future plans do you bring? (300 words max)