Licensed Lay Worship Leaders Application for Initial Licensing

The new handbook from The General Council is found by clicking here.

*PLEASE NOTE: Applications for the initial licensing will be addressed upon receipt. All licenses for the Licensed Lay Worship Leaders in the Fundy St. Lawrence Dawning Waters Regional Council will be reviewed annually for the first two years. Following that, the license may be granted for up to two years. This review will be initiated by the LLWL. The application for re-licensing will be found on the regional council web site.

Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email*
Primary Phone*
Secondary Phone
Home Community of Faith*
Home Community of Faith Address*
City State / Province / Region
Brief faith statement (500-700 words)*
Confirmation of Completion of mandatory Boundaries training (or confirmation of being on a waiting list)*
Please enter if this is the date completed or date of joining waiting list. Enter date in MM/DD/YY format. (ie "Completed 12/15/97" or "Joined 12/15/97")
Confirmation of willingness to participate in the Racial Justice training.*
- I am willing and will register for the on-line training
- I have registered for the on-line training to be held
Police Records Check (PRC)*
Please enter the year you received your PRC (note that PRCs are good for five years).
Please describe the training you have planned: (Atlantic Residential, United in Learning online, Atlantic School of Theology certificate, previous biblical/Theological training, other)*
Date of completion of training planned (above)*
MM slash DD slash YYYY
What plans do you have for on-going education in the coming year(s)? (Please see the LLWL handbook, pages 9-11 for suggestions)*
Reference letter from an instructor or facilitator as to suitability for leadership.
Max. file size: 64 MB.
If you are unable to upload a file please mail directly to Brian DeLong, 1245 Kingsley Road, Birdton, NB E3G 6E1.
If successful, I will/will not give permission to have my name added to the list of those LLWL’s to serve throughout Fundy St. Lawrence Dawning Waters*
- I will
- I will not
I am prepared to travel up to the below number hours to serve as LLWL
I am prepared to travel up to the below number of kms(return) to serve as LLWL
Consent*
I am aware of and have considered the LLWL handbook, 2019, and agree to the process outlined therein including outline of eligible services and limitations to these services, training requirements including the need to have taken the Boundaries Training of The United Church of Canada: *
Date*
MM slash DD slash YYYY
Action of the Community of Faith
Please upload a document that includes the date and motion of support/recommendation from the governing body of your home community of faith; signature of representative of Faith Community; and signature of ministry personnel of faith community or pastoral charge supervisor. If you are unable to upload a file please mail directly to Barbara Prowse, 413- 215 Mina Jane Drive, Charlottetown, PEI C1E 3M8.
Max. file size: 64 MB.
Contact Information*
Please let us know if you give permission to include your name and contact information on the Regional website.
- Yes, I give permission for my information to be shared on the Regional website
- No, I do not give permission for my information to be shared on the Regional website
PLEASE NOTE: Applications for the initial licensing will be addressed upon receipt. All licenses for the Licensed Lay Worship Leaders in Fundy St. Lawrence Dawning Waters Regional Council will be reviewed annually for the first two years. Following that, the license may be granted for up to two years. This review will be initiated by the LLWL. The application for re-licensing will be found on the Regional Council website under "Forms".
Office Use:

Action of Fundy St. Lawrence Dawning Waters Regional Council Pastoral Relations Committee:

We Approve: Yes / No

Date: ______________

Signature (either the Secretary or Chair of Pastoral Relations Committee): _________________________

Office Use:

Action of Fundy St. Lawrence Dawning Waters Regional Council Pastoral Relations Committee:

We Approve: Yes / No

Date: ______________

Signature (either the Secretary or Chair of Pastoral Relations Committee): _________________________

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