Please complete the form below, then submit your tuition payment.

  1. I understand that I will have eighteen (18) calendar months to complete the Deaconry Training Program. 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 Manditory.

DTP Course Registration Form
Section I: Identifying Data and Demographics
*First Name: 
Middle Initial: 
*Last Name: 
*Address: 
Address 2: 
*City: 
*State: 
*Zip: 
Country: 
Home Telephone: 
*E-Mail: 
URL: 
*Date of Birth: 
*Age: 
*Citizenship: 
*Place of Birth: 
Marital Status: 
Spouse's Name: 
Children (Names and Ages): 
Education: 
Please list highest degree,
school and date of graduation


Section II: Background
Previous or Current Craft Training:
Have you applied for any other craft training? YESNO
If yes, please list:
Have you applied for sponsorship or support for a group from any organization other than the SWC? YESNO
If yes, please provide the name,
contact point and status of your application:
Section III: Military Affiliation (If none, skip to Section IV)
Branch:
Status:
Position:
Rank/Grade:
Relationship to Sponsor:
Are you are interested in forming a group?
Or having an existing group supported or sponsored by SWC under military accommodation policies for Distinctive Faith Groups?
YESNO
(If you answered "No" to the previous question, skip to section IV)
Chaplain's Name and Rank:
Chaplain's Mailing Address:

Chaplain's Military Phone:
Chaplain's Commercial Phone:
Chaplain's E-mail:
Have you or a member of your group
spoken with this Chaplain?
YESNO
If yes, please provide a brief synopsis of the meeting:
Section IV: Autobiographical Summary
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:
Section V: Conditions and Certifications
I understand that if I am accepted to the Sacred Well Congregation Deaconry Candidate Program I will be expected to complete the prescribed training course within a period of 18 Calendar months from the time of my enrollment.
I also understand that I must remain an annual supporting member (or above) to retain my status.
The information submitted with this form is true and accurate to the best of my knowledge.
My Name and Date below constitute the authentication of this form.
Applicant's Name:
Date Submitted: