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Coaching Application

Please fill out every text box. If you want to skip one, please enter "0" in that place.
Name
   
Application Date
    / /         Year Ordained
Email Address
     Phone No.
Ministry Location
   
   (Name of Congregation or Institution where you are serving)
Address Line 1
   
Address Line 2
   
City
     State  Zip
Would you like to request
a specific coach?
    Yes     No
Name of coach requested
   
   (Matching of coaches is dependent on availability)
Billing Information
 The cost for 12 sessions of coaching within a 6-month period is $600.00. Participating synods assume responsibility for a portion of the costs. Pastors are encouraged to contact their synod to determine the amount of their synod's contribution. Pastors receiving coaching, or the congregation they serve are responsible for the remaining amount.
Snyod/Judicatory contribution
   
Self/Congregation contribution