Online Clergy Application Step 1 of 4 25% Personal InformationName First Last Preferred Name / NicknameEmail Preferred Phone NumberAddress Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Clergy StatusAre you an ordained minister?YesNoDate of OrdinationChurch or denomination:Clergy status (i.e., licensed, certified, deacon, etc.):Current professional ministry (i.e. Pastor, Chaplain, etc.):StatusFull TimePart TimeIf a pastor, what church(es) do you currently pastor?Are you retired in good standing?YesNoHome Church Educational BackgroundSchoolYearDegreeSchool #2SchoolYearDegree Emmaus / Chrysalis ExperienceIn what Community and when did you make your Emmaus Walk, or other Upper Room Event?When did you complete Fourth Day Training?Have you attended Emmaus/Chrysalis Clergy training conducted by The Upper Room staff or a Clergy Regional Representative?YesNoIn what Community and when?Previous Teaming experience as a layperson (Community name, Walk/Flight number, jobs held):Previous Teaming experience as clergy (Community name, Walk/Flight number, jobs held):Have you served on previous teams before? (not as clergy)YesNoPlease list the walk numbers and positions held for previous teams.Please check any of the Emmaus / Chrysalis Clergy talks listed below that you have given: Prevenient Grace God Designed You Justifying Grace God Loves You Means of Grace God’s Gift to You Obstacles to Grace God Sustains You Sanctifying Grace God Empowers You None Have you served as the Weekend/Head Spiritual Director on a Walk / Flight?YesNoCommunity and Walk / Flight number:Emmaus/Chrysalis Community Activities you have participated in (check all that apply): Group Reunion Gatherings Sponsors Hour Candlelight Background Service Closings Sponsoring Agape Support Committees Board Member Other None If other, please specify:Team Participation Expectations: Team formation is a 23–26 hour process, typically conducted over a series of evening meetings, prior to the weekend event. Team members are expected to attend all team meetings and to preview their talks. Specific team meetings that must be missed shall be coordinated with the Weekend Spiritual Director and the Weekend Lay Director. The WSD and at least one AWSD must commit to stay for the entire weekend to minister to the Pilgrims and Team. The cost to the Richmond Emmaus Community for each team member on a Walk currently is $200.00. Spiritual Directors are asked to contribute at least $100.00 towards this cost.