Licensed Lay Worship Leaders Application for Initial Licensing

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)*

Specifically, please address these questions: "Where do you feel you have grown?" and "Where do you feel you need to develop more?"

Confirmation of completion of mandatory Boundaries training (or confirmation of being placed 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 mandatory Racial Justice training (or confirmation of being placed 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")

Proof of Police Records Check, including vulnerable sector.

If you are unable to upload a file please mail to Regional Council 15 LLWL, 21 Wright Street, Sackville, NB E4L 4P8.

Max. file size: 64 MB.

What training have you completed: (Atlantic Residential, United in Learning online, previous biblical/Theological training)*

Date of completion of training planned (above)*

Reference letter from an instructor as to suitability for leadership.

If you are unable to upload a file please mail to Regional Council 15 LLWL, 21 Wright Street, Sackville, NB E4L 4P8.

Max. file size: 64 MB.

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*

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 to Regional Council 15 LLWL, 21 Wright Street, Sackville, NB E4L 4P8.

Licensed Lay Worship Leaders Application for Initial Licensing

Office Use:

Action of Regional Council 15 Licensing Committee:

We Approve: Yes / No

Date: ______________

Signature: _________________________

United Church of Canada News

Licensed Lay Worship Leaders Application for Initial Licensing

Office Use:

Action of Regional Council 15 Licensing Committee:

We Approve: Yes / No

Date: ______________

Signature: _________________________

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United Church of Canada News