Name(as it appears on your state-issued Driver’s License or government-issued ID) First Last Date of Birth MM DD YYYY Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code PhoneEmail Diocese of Canonical ResidenceName of Local Diocesan SchoolDate of Graduation from Local Diocesan SchoolDate(s) of OrdinationDeacon / Priest, where applicableMost Convenient Airport for TravelIf you currently serve as a DeaconVocationalTransitionalName and Address(es) of Congregation(s) You Serve or Your Ministry Site(s)Years in service to this/these congregation(s)/ministry site(s)In order to ensure that your congregation/ministry site and your diocese support your participation in TBVM, please provide the following information:Name of one congregational/ministerial leader and contact informationName of one diocesan leader and contact informationIn one paragraph, please describe what draws you to your first choice of courses above. Be sure to include what experience, and prior course work, if any, you’ve had in this area and outline what you hope to learn through your participation in this particular course.CAPTCHA
