Certification Commission Policy and Procedure Manual

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APPENDIX 3-C cont’d CERTIFICATION COMMITTEE SAMPLE 3 REPORT OF COMMITTEE ACTION EXTENSION OF CANDIDATE OR ASSOCIATE SUPERVISOR STATUS APPLICANT: ADDRESS: DATE: REGION: TRAINING CENTER: SUPERVISOR: PRESENTER: APPLICANT’S REQUEST: Extension: ___ Candidate status ___ Associate Supervisor status COMMITTEE ACTION: __________ Granted ___________ Denied ______________________________________________________________________________ Summary of Interview Process: Evaluate Applicant’s Rationale for Requesting an Extension: 3 Sample form adapted from a form developed by the ACPE Eastern Region 18
APPENDIX 3-C cont’d APPLICANT: Page 2 Evaluate the Applicant’s Response to Recommendations or Suggestions (or notations in the Case of Associate Supervisor) Given by Previous Certification Committees: Summarize the Applicant’s Supervisory and Supervisory Related Activities since the last Committee Appearance: Suggestions: NOTE: NOTATIONS MAY BE REMOVED ONLY BY THE CERTIFICATION COMMISSION COMMITTEE MEMBERS: (Please Print) _____________________________________ Presenter _____________________________________ Committee chair _____________________________________ _____________________________________ _____________________________________ ______________________________________ _____________________________________ Regional Accreditation Committee Chair 19
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 16 and 17: APPENDIX 3-B cont’d REGIONAL CERT
Page 18 and 19: APPENDIX 3 B cont’d APPLICANT: Pa
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

Certification Commission Policy and Procedure Manual

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