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CPE Application Form

Contact & Basics

How did you hear about our program?

Eligibility & Track

Track Preference
Regular Unit - approximately 12 weeks
Extended Unit - approximately 24 weeks
Not sure — I would like guidance
Planned Start
January 2027
April 2027
A later 2027 cohort
Not sure — I would like guidance

Placement Plan

Do you have a potential local clinical placement site?
Yes
Possibly
Not yet
I would like guidance
Site Type - check all that apply
On-Call Openness
Yes
No
Not Sure

References

Accessibility & Scholarships

Scholarship Need
Yes
No

Agreements & Uploads

I understand that Clinical Pastoral Education is an intensive professional training program requiring:

  • Completion of at least 400 hours per unit, ordinarily consisting of approximately 300 clinical hours and 100 hours of education and supervision.

  • Participation in scheduled cohort learning, individual and group clinical supervision, case consultation, didactics, and reflective group work.

  • Timely completion of the Learning Contract, case studies, reflective writing, Mid-Unit Self-Assessment, Final Self-Evaluation, and other assigned work.

  • An approved clinical placement and compliance with all site onboarding, safety, confidentiality, documentation, and scope-of-role requirements.

  • Reliable internet access, a functioning camera and microphone, and a private setting appropriate for confidential online participation.

  • Professional conduct, responsible attendance, appropriate interpersonal engagement, and openness to reflective learning.

  • Careful protection of patient, family, staff, trainee, and institutional confidentiality.

On all uploads, do not include protected health information or patient identifiers.

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Equipping Chaplains.
Strengthening Institutions.
Transforming Care.
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