Fall 2012 Professional Practitioner Studies Program Application Professional Practitioner Studies Program Application Instructions 1. Refer to Practitioner Education Program catalog course prerequisites on page 8 to verify you have completed required coursework. Any questions, please call Education Registrar at (720) 974-2242. 2. Read and sign Mile Hi Church Training and Licensing Process letter 3. Complete Application. Internet Users: If you download a copy from our website the forms can be filled in but you cannot save a copy. Remember to print copies of the forms; one to submit with your paperwork to the Core Education Registrar and one for your records. 4. Non-refundable $30 application fee 5. Recent photo attached to application 6. Signed Background Screening Consent Waiver 7. Complete History of Certificated Classes a. Classes taken in other spiritual communities will require either copies of certificates or transcript from the community the corresponding class was taken. Note: It is important that all information be accurate as it will be used and verified by Centers for Spiritual Living (CSL) for your practitioner license. 8. Complete Workshop Prerequisite History 9. Submit completed application packet by mail or in person to the church administrative office. Mile Hi Church Attn: Education Registrar 9077 W. Alameda Avenue Lakewood, CO 80226 Note: Application deadline: August 30th,, 2011. No applications will be processed after August 30th. Any questions, please contact Education Registrar at (720) 974-2242 2 May 1, 2011 Re: Mile Hi Church Practitioner Training and Licensing Process Dear Practitioner I Students, We offer our heartfelt congratulations on pursuing the path of studies that can lead you to licensing by our parent organization, the Centers for Spiritual Living. The curriculum that we teach each week is provided to us by CSL and is the baseline for what is required to pass the Professional Practitioner Studies Program at Mile Hi Church. Over the two year program each student must complete Facilitator Training, a total of 6 Voice Dialogue sessions, 6 different Practitioner sessions and one of Dr. Roger’s Meditation Retreats. These requirements, along with the course curriculum, are intended to prepare you to pass both your written and your oral exam in your final year of Professional Studies. If you have any questions about your class requirements, please contact the registrar at (720) 974-2242 or consult the Practitioner Professional Studies course catalog. Although, the majority of practitioner students do pass the licensing exam process, not all students have passed and become licensed Practitioners. The preparation we offer is not a guarantee that you will pass the written or oral exam. It is important to note that the work of preparation must go beyond just an intellectual understanding of the Science of Mind and Spirit principles and must include a corresponding heart application of these teachings. Your ability to incorporate SOMAS in your heart and mind could be assessed in either your final written or oral exam. In some cases a postponement may occur and a minimum of a one year delay in licensing could take place. It is important to clear any issues that could be a block to being fully in service to Mile Hi Church or the church that will hold your license. It is important to be heart connected with SOMAS principles to become a practicing practitioner. Unhealed areas have a way of showing up in either of the licensing exams. The Oral Exam will be given in the presence of a licensed minister and 2 licensed practitioners. We want to be clear on the licensing requirements with all practitioner students as you enter and continue your preparation studies. We would appreciate it if you would please sign this letter as indication that this communication has been received. Thank you and Blessings on your Continued Path, Dr. Patty and Rev. Ras _________________________________________________ Student Name Date 3 Mile Hi Church Professional Practitioner Studies Program Practitioner I Application (Please type or legibly print all information) Name:____________________________________________________________ Social Security Number:____________-_____________-_____________ Address:__________________________________________________________ Home Phone:_________________________ Work Phone: _________________ Other Phone:_________________________ Fax :________________________ E-Mail Address:____________________________________________________ Date of Membership to Mile Hi Church:__________________________________ (Membership required 18 months before completing Prac II) What activities have you participated in at Mile Hi Church? _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ What other Religious Science Churches/Centers have you previously attended? _________________________________________________________________ _________________________________________________________________ What activities did you participate in at your previous church? _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ 4 Educational Background Institution Dates of Attendance Degree/Certificate _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ List activities, such as hobbies you enjoy, civic or professional involvement: _________________________________________________________________ _________________________________________________________________ List any training programs that you have taken that you feel are part of your preparation for spiritual leadership (include dates): _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ The following are the basic requirements for entrance into the Professional Practitioner Studies Program. Please use a separate sheet of paper, include the number of the statement, and write a brief statement of how this applies in your life. 1. Demonstrating Universal Principles as taught in SOM is of primary importance in my life. 2. I am emotionally and socially mature in all of my personal and professional relationships. 3. I think and act independently. I take initiative and take responsibility for my own actions in both problem-solving and goal accomplishment. 4. I have a love of learning and self-knowledge. I am open to suggestions and avenues for change in my life. 5. I am financially secure and responsible. 6. I maintain a professional attitude, which exemplifies the high standards of the call to spiritual service, through my personal appearance, integrity and ethical judgment. 5 Statement of Purpose Please use a separate sheet of paper to discuss the following questions. Respond openly and honestly to each question. 1. Discuss the primary reasons for your desire to become a Religious Science Practitioner. 2. Discuss your attributes and liabilities in pursuing this path? What kinds of things do you do particularly well? What are areas that need strengthening? What are your limitations? Do you have time and energy to devote the Practitioner Studies? 3. Discuss how your life experiences have shaped you for your call to Practitioner Studies? I have successfully completed the prerequisite courses and workshops as outlined in Page 8 of the Practitioner Professional Studies Program Catalog. I understand that being accepted into the Professional Practitioner Studies Program does not in any manner suggest that I will automatically be accepted into Practitioner II. I must successfully pass Practitioner I and the Practitioner II continuation interview. I further understand that all class tuition and other fees must be paid in full as outlined in the course catalog. I understand that my acceptance into the program means I am expected to honor the professional and ethical standards of the Practitioner Code. NOTE: An appointment will be scheduled for your Admissions Panel Group Orientation after your application is reviewed. Applicant Signature________________________________ Date___________ 6 Professional Practitioner Studies Program Mile Hi Church Background Screening Consent Applicant should complete all relevant information and sign and date the form. I,___________________________________, hereby authorize MILE HI CHURCH and/or its agents to make an independent investigation of my background, past employment, education, adult criminal or police records including those maintained by both public and private organizations and all public records for the purpose of confirming the information contained on my Application and/or obtaining other information which may be material to my qualifications for my entry into Practitioner Studies at Mile Hi Church. I release MILE HI CHURCH and its agents and any person or entity, which provides information pursuant to this authorization, from any and all liabilities, claims or law suits in regards to the information obtained from any and all of the above referenced sources used. The following is my true and complete legal name and all information is true and correct to the best of my knowledge: Full Name (printed) ________________________________________________ Maiden Name or Other Names Used __________________________________ Social Security Number __________ - __________ - ____________ Date of Birth ____________ / ____________ / ____________ Present Address __________________________________________________ City ______________________________ State ___________ Zip __________ How long at former address? ________________________________________ Please list all states of residence since turning age 18: ____________________ ________________________________________________________________ ________________________________________________________________ Signature of Applicant Date 7 History of Certificated Classes 180 hours of Certificated Science of Mind classes are mandatory to enter Professional Practitioner Studies Program Student Name______________________________________________________________________ Address___________________________________________________________________________ City __________________________________ State ____________ Zip Code __________________ Phone___________________________ email____________________________________________ Other name(s) under which previous classes may have been filed: _____________________________ Please complete the information below. For classes taken at other spiritual communities, please attach a copy of Certificates of Completion or obtain a transcript from the community the corresponding class was taken. If unsure of any of your records, contact the spiritual community where the course was taken. Class Name Date Completed Instructors Name Other Spiritual Community name & address SOM I or SOMAS 101 SOM II or SOMAS 201 SOM III or SOMAS 301 SOMAS 401 – Ernest Holmes SOMAS 402- Thomas Troward SOMAS 501-Practical Mysticism SOMAS 601-Technologies of Conscious Living Other communities classes Practitioner I Practitioner II If you need any assistance filling out this form, please contact Registrar at (720) 974-2242. 8 Professional Practitioner Studies Program Workshop Prerequisite History Note: All workshops must be current within last five years prior to application Workshop Name Date Taken 3 of 6 Required Bridge Of Dreams Bridge of Awakening Bridge of Expression What Will Set You Free What Will Set You Free Level II Inner Child Journey 9