Certification Commission Policy and Procedure Manual
Certification Commission Policy and Procedure Manual Certification Commission Policy and Procedure Manual
APPENDIX 3-B cont’d REGIONAL CERTIFICATION COMMITTEE SAMPLE 2 SUPERVISORY CANDIDATE STATUS REPORT OF ACTION APPLICANT: DATE: ADDRESS: TRAINING CENTER: REGION: SUPERVISOR: PRESENTER: APPLICANT’S REQUEST: Supervisory Candidate Status COMMITTEE ACTION: __________ Granted ___________ Denied ______________________________________________________________________________ Documentation of Formal Requirements: ___ YES ___ NO Copies of college & seminary diplomas or transcripts or documentation of M Div equivalency: ___ YES ___ NO Ordination or Commission to function in ministry/rabbinate by an appropriate religious authority: ___ YES ___ NO Faith Group Endorsement (if applicable) (See Appendix 5 ACPE Ecclesiastical Endorsement Conflict Resolution Policy) ___ YES ___ NO M.Div. or Equivalency. ___ YES ___ NO ACPE clinical membership and Accountability for Ethical Conduct Policy Report Form: ___ YES ___ NO Completion of at least one unit of Supervisory CPE Briefly evaluate the applicant’s written materials: APPENDIX 3-B cont’d 2 Sample format, adapted from a form developed by ACPE Eastern Region 14
APPLICANT: Page 2 Summary of Interview::(how the applicant engaged committee & committee engaged the applicant) Evaluate: 1. Applicant’s demonstrated pastoral competence and articulation of a pastoral theology. 2.Applicant’s understanding of personal history and strengths and weaknesses as a supervisor. 3. Applicant’s capacity to articulate a theological understanding of life from within the applicant’s tradition. 15
- Page 1: Certification Commission Policy and
- Page 4 and 5: CERTIFICATION COMMISSION POLICY AND
- Page 6 and 7: completing the Regional Certificati
- Page 8 and 9: Appendices APPENDIX 1 ACPE CERTIFIC
- Page 10 and 11: APPENDIX 2-A ACPE CERTIFICATION COM
- Page 12 and 13: APPENDIX 3-A CONSULTATION ON READIN
- Page 14 and 15: APPENDIX 3-A cont’d CONSULTEE: Pa
- Page 18 and 19: APPENDIX 3 B cont’d APPLICANT: Pa
- Page 20 and 21: APPENDIX 3-C cont’d CERTIFICATION
- Page 22 and 23: APPENDIX 3-D The report of this mee
- Page 24 and 25: APPENDIX 3 D cont’d APPLICANT: Pa
- Page 26 and 27: APPENDIX 3 E REQUEST FOR ACPE SUPER
- Page 28 and 29: APPENDIX 3-E cont’d APPLICANT: Pa
- Page 30 and 31: APPENDIX 3-F APPEARANCE FOR REVIEW
- Page 32 and 33: APPENDIX 3 F cont’d INTERVIEWEE:
- Page 34 and 35: APPENDIX 3 G CONSULTATION TO MAINTA
- Page 36 and 37: APPENDIX 3 I COMMITTEE CONSULTATION
- Page 38 and 39: APPENDIX 5 ACPE ECCLESIASTICAL ENDO
- Page 40 and 41: ASSOCIATION FOR CLINICAL PASTORAL E
- Page 42 and 43: Declaration Procedures for Candidat
- Page 44 and 45: 6. How are persons prepared and tra
- Page 46 and 47: ________ 5. Is this group listed in
- Page 48 and 49: (Practical application: Is the theo
- Page 50 and 51: Appendix 11 Instructions from the C
- Page 52 and 53: e, and should not become, a continu
APPLICANT:<br />
Page 2<br />
Summary of Interview::(how the applicant engaged committee & committee engaged the<br />
applicant)<br />
Evaluate:<br />
1. Applicant’s demonstrated pastoral competence <strong>and</strong> articulation of a pastoral theology.<br />
2.Applicant’s underst<strong>and</strong>ing of personal history <strong>and</strong> strengths <strong>and</strong> weaknesses as a<br />
supervisor.<br />
3. Applicant’s capacity to articulate a theological underst<strong>and</strong>ing of life from within the<br />
applicant’s tradition.<br />
15
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