CLERGY APPLICATION FOR EMMAUS/CHRYSALIS ...

CLERGY APPLICATION FOR EMMAUS/CHRYSALIS TEAM (Please type or print in black ink) The Weekend Spiritual Director is the primary clergy leader of the Emmaus or Chrysalis event. The Weekend Spiritual Director is selected by the Board of Directors with the recommendation of the Emmaus or Chrysalis Community Spiritual Director and is responsible to the board as a leader of the Emmaus or Chrysalis weekend. As with the Lay Director, the weekend Spiritual Director must have sufficient experience, training, and ability for the job The Assistant Spiritual Directors are selected by The Team Selection Committee and the Community Spiritual Director. These Assistant Spiritual Directors will assist the Weekend Spiritual Director in the clergy duties for the weekend event. Name _______________________________ Name you like to be called _________________ Address ____________________________________________________________________ Street City State/Zip Home Telephone _____________________ Work Telephone _________________________ E-mail Address (home) ______________________ (work) ___________________________ Your church relationship: Are you an ordained minister? ______Y______N, Date of ordination ___________________ What is your clergy status (i.e. license, certified, deacon, etc.)_________________________ In what church or denomination? _______________________________________________ What is your current professional ministry (i.e. pastor, chaplain, etc.) __________________________________________________________________________ Full-time _____________ Part-time__________ If a pastor, church (es) you currently pastor: __________________________________________________________________________ __________________________________________________________________________

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Your educational background: Please list the theological school(s) you have attended, the date(s) of graduation(s) and degree(s) you have earned in your ministerial training: School Year Degree ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Are you a retired minister in good standing ?______ If yes, what is your home church? ______________________________________________________________________________ Your Emmaus and Chrysalis background: Where and when did you make your Emmaus Walk, or other 4th Day weekend (please specify)? ____________________________________________________________________________ Have you attended an Emmaus/Chrysalis clergy training conducted by The Upper Room staff or a Clergy Regional Representative ?_______Y________N If yes, date & community________________________________________________________ Previous Team experiences as a layperson (Please list by Community name followed by Walk/Flight/Journey number, jobs held, talks given) ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Previous Team experiences as a clergyperson (Please list by Community name followed by Walk/Flight/Journey number) ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ For the Emmaus and Chrysalis Clergy talks listed below, please check all that you have given. Prevenient Grace God Designed You Justifying Grace God Loves You Means of Grace God’s Gift to You Obstacles to Grace God Sustains You Sanctifying Grace God Empowers You Page 2 of 3

Have you ever served as the Weekend/Head Spiritual Director on a Walk/Flight/Journey? If yes, give the community name and Walk/Flight/Journey number ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ What Emmaus/Chrysalis Community Activities have you participated in? ___Group Reunion ___Gatherings ___Sponsors Hour ___Candlelight ___Background service ___Closings ___Sponsoring ___Agape Support ___Committees ___Board Member ___Hoot ___Other (Explain) ____________________________________________________________________________ Expected team participation: Team formation is a 23 to 26 hour process prior to the weekend event. It is understood that clergy are expected to attend all of the team meetings and preview their talks. Specific team meetings that you would need to miss are coordinated with the Weekend Spiritual Director and the Weekend Lay Director. There shall be at least two clergy persons (WSD & AWSD) who will stay for the entire weekend for purposes of training and support. ___________________________________________________________________________ Signature of Applicant Date

Please complete this form and mail it to your Emmaus/Chrysalis Community Spiritual Director. (11/15/06) Page 3 of 3