"*" indicates required fields Date Completed* MM slash DD slash YYYY Applicant Name* First Last Home Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Email* Home congregation or institution (Name and City)*Program/Activity InformationName of program or activity for which authorization is requested*What are your continuing education goals for this year?*Scheduled date(s)*Location*What group/institution is offering this program/activity?*Teacher/supervisor*What are your continuing education goals for this year?*How do you anticipate this proposed project will help you meet your goals?*Have you participated in a continuing education project under the Diocesan Education Funds program?* Yes No If you answered yes above, when? MM slash DD slash YYYY Are all previous evaluations on file?* Yes No Anticipated ExpensesFee/tuition*Travel*Room/board*Books/resources*You must be prepared to pay not less than 1/3 of the total cost of the project as your portion for participating in the Continuing Education Program. The diocese will provide matching funds for up to 1/3 of the program, up to a maximum of $350 on an annual basis. Please list the amount your parish is donating, the diocesan donation and your personal donation in the field below:*Clergy/Warden in Charge (who can verify congregational contribution) - name, phone number and email address*Post-Education EvaluationSubmission of the post-education evaluation is mandatory and can be found on the diocesan website or obtained from the chairperson.Do you accept the obligation to submit the completion of the proposed project? Yes No Questions?Once your course is complete, please complete the Continuing Education Completion Report (available on our website: https://office.diowestmo.org/continuing-education-completion-report-form/). If you have questions, please contact The Rev. Anne Meredith Kyle, Vocations Missioner, at vocations@diowestmo.org. CAPTCHAPhoneThis field is for validation purposes and should be left unchanged.
