Spiritual Care Visitor Training Application

For more information and questions, contact Kim Lessner at 312-563-4825 or Kim_Lessner@rush.edu.

Class size is limited to 20 students.  Please register early!

Application for Enrollment — Spiritual Care Visitor Training

"*" indicates required fields

I am registering for (please select one - all times are local time zones)*
Name*
Address*

Spiritual Information

We would like to learn more about you. Please briefly answer the following questions.
Application Fee*
Optional Donation
Background Check

Electronic Signatures

Please share the name, email, and phone number of your mentor who can speak to your aptitude supporting individuals you’ll be supporting spiritually and emotionally. This could be a faith community leader if you are active in your church/synagogue/temple/mosque, sangha; a social worker if you volunteer at a social justice organization or a hospice; or a supervisor at work who is familiar with your spiritual and emotional maturity. This person will be your mentor and support you while in the program and beyond. By signing the application, you give us permission to contact this person.
Mentor's Name*
Authorization of Electronic Signature*
Your Name*
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