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How to Find Us
Public Transit to our Office
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Newsletters
Donate
Partners
Chaplaincy
Spiritual Care
Chaplain Fellow at Stroger Hospital
Dianna’s Teddy Bear Ministry
Clinical Pastoral Education
Ministry to the Deaf Community
Social Justice
Spirituality & Wellness
Self-Care Events
Healing One–Healing the World Resource Page
Spiritual Care in the Midst of Social Distancing
Self Care for Medical Workers
Ways to Combat Stress
Why Healing One, Healing the World?
The Arts Can Soothe
Advance Care Planning Resources
Spiritual Care Visitor Training
Overview of Training
How Spiritual Care Training Can Change Your Life
Spiritual Care Visitor Training Payment
Spiritual Care Visitor Training Online Module Access
About Us
Mission & History
What We Do
Our Video Story
Board of Trustees
Our Staff
Friends of the House
How to Find Us
Public Transit to our Office
Annual Reports, Audits and Financials
Newsletters
Donate
Partners
Chaplaincy
Spiritual Care
Chaplain Fellow at Stroger Hospital
Dianna’s Teddy Bear Ministry
Clinical Pastoral Education
Ministry to the Deaf Community
Social Justice
Spirituality & Wellness
Self-Care Events
Healing One–Healing the World Resource Page
Spiritual Care in the Midst of Social Distancing
Self Care for Medical Workers
Ways to Combat Stress
Why Healing One, Healing the World?
The Arts Can Soothe
Advance Care Planning Resources
Spiritual Care Visitor Training
Overview of Training
How Spiritual Care Training Can Change Your Life
Spiritual Care Visitor Training Payment
Spiritual Care Visitor Training Online Module Access
Spiritual Care Visitor Training Application
Ann Ryba
2020-06-18T15:55:28-05:00
Spiritual Care Visitor Training Application
For more information and questions, contact Kim Lessner at 312-563-4825 or
Kim_Lessner@rush.edu
.
Application for Enrollment — Spiritual Care Visitor Training
Name
*
First
Last
Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Swaziland)
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Réunion
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen Islands
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Preferred Phone Number
*
Email
*
Spiritual Information
We would like to learn more about you. Please briefly answer the following questions.
Please share briefly about a spiritual practice that you participate in that you find meaningful. A few examples might be: (prayer, reading scripture, attending worship, meditation).
*
What are your perceived gifts for ministry and how would you like to utilize them at the completion of the training?
*
How will your training as a spiritual care visitor contribute to your faith community?
*
If you’ve had the experience of making spiritual care visits, please tell us about a visit.
*
As part of the program you will be asked to engage in ministry two hours each week. Do you have ideas for this?
*
Application Fee
*
Please follow link to submit your $50 application fee online. The application fee is non-refundable. A balance of $325 will be due upon acceptance to the program. Tuition is non-refundable once you have been given access to the online learning system. You can
make a payment here
.
Background Check
*
Once you submit the form, you will receive a link via email from Kim at KIm_Lessner@rush.edu concerning your background check. Click the link and complete the background check information. Please email Kim if you don’t receive a link within 3 days.
If you have had a background check in the past three years please provide the name, phone number and email address of who we can contact to obtain the information.
Electronic Signatures
Please share the name, email, and phone number of a leader from your Faith Community that can speak to your gifts for being a spiritual care visitor. By signing the application, you give us permission to contact this person.
Name of Faith Community
*
Faith Community Leader's Name
*
First
Last
Faith Community Leader's Phone
*
Faith Community Leader's Email
*
Authorization of Electronic Signature
*
I agree that this will be used as my electronic signature.
Your Name
*
First
Last
Date
*
Date Format: MM slash DD slash YYYY
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