Office of Formation and Leadership Development

28th June, 2011 - Posted by admin - No Comments

Success! Your Clergy License Application Information has been received.

This form provides all information regarding your education and continuing education credits during the last year.

First Name(required)
Last Name(required)
Email Address(valid email required)
Check this box if you are requesting a Retired Limited License to Practice and are NOT required to complete information regarding education or continuing education.
Check - then scroll down to Sign/Subit the form.

Section 1: Education

Please indicate any degrees or certifications completed since filing your last Status Form
Degree/Certification
Degree/Certification
Degree/Certification
Others?

Section 2: Continuing Education

A total of 9 hours of continuing education per year is required per the MCC Clergy Manual. Continuing education is any workshop, class, conference, or other education program that equips you for continued professional ministry in MCC. Please attach proof of completion of any continuing education listed.
CEU #1
Title of Workshop/Course
School or Organization
Presenter Name(s)
Location of Workshop/Course
Number of Qualifying Hours
Upload Certificate (.jpg, .pdf, .doc formats only)
CEU #2
Title of Workshop/Course
School or Organization
Presenter Name(s)
Location of Workshop/Course
Number of Qualifying Hours
Upload Certificate (.jpg, .pdf, .doc formats only)
CEU #3
Title of Workshop/Course
School or Organization
Presenter Name(s)
Location of Workshop/Course
Number of Qualifying Hours
Upload Certificate (.jpg, .pdf, .doc formats only)
Signatures
Signature Full Name(required)
Date of Signature(required)
By checking this box, I certify this information is true and correct to the best of my knowledge and I have signed it electronically in good faith.
Check this box to receive a copy of your Education and Continuing Education Information.
Form Verification (Type the code you see into the box)

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