SPIRITUAL DIRECTION INTERNSHIP INITIATIVE
Application for Admission to Certificate Program in Spiritual Direction
339 Jerusalem Road
Cohasset, MA 02025

617-680-6815
retreat@csjretreatcenter.org
www.csjretreatcenter.org
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Name:
Last: First: Middle:

Address Street:

Address City: .. State: Zip:

Telephone: Social Security Number (optional)

1. E-Mail Address :

2. Retype E-Mail Address :

Date of Birth: Month: Day: Year:
Place of Birth:

Religious Affliation:
If you are a vowed or associate member of a Religious Congregation, please add the name of the congregation.

Place of Employment:
Occupation:..............

Please list all the colleges and graduate schools you have attended.

1. Institution: Location:

Dates attended:

Degree or Certificate: Degree Granted:

.................................................................................................................

2. Institution: Location:

Dates attended:

Degree or Certificate: Degree Granted:

.................................................................................................................

Dates attended:

Degree or Certificate: Degree Granted:

.................................................................................................................
4. Institution: Location:

Dates attended:

Degree or Certificate: Degree Granted:

Undergraduate Field(s) of concentration:

Graduate Field(s) of concentration: ........

How have you been employed since finishing college? Please list type of work, where, when.

Please list any other ministerial or pastoral activities in which you have been engaged.

List the names of the three persons from whom you will request references. At least one of these persons who can comment on your potential as a spiritual director should have known and worked with you but not in a teacher-student relationship.



Personal Statement:

Please compose a statement of about 500 words in which you touch on the following:

a.) Your family background;
b.) Your understanding of spiritual direction;
c.) What you hope to do as a spiritual director;
d.) On the basis of your experience, what do you regard as your principle strengths for this ministry and your areas of development;
e.) Why you are applying to the Spiritual Direction Internship;
f.) What is the feasibility of your finding 2-3 directees with whom you will meet bi-weekly from late September until mid May?

Date:

Thank you.

Admission Requirements:

1.) Completed Application Form
2.) Three completed Reference Forms
3.) Personal Statement
4.) Personal Interview

Your $50 non-refundable application fee can be brought on the day of your interview.
Please make your check payable to Spiritual Direction Internship Initiative.


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