Format for Requesting Approval of Youth Ministry Training Programs for Certification

In seeking approval for clock hours towards Catechist Certification, the following information is needed:

1.	TITLE or TOPIC of Program:
2.	DATE(S) (Including year):
3.	PLACE(S):
4.	TIME(S):
5.	Description and projected number of PARTICIPANTS:

6. Who will be the Leader(s) of the session(s) of this program?

	Name	Ministry Experience	Academic Degrees	Level of Certification
a.
b.
c.

7. Give a full description of the topic area:

If the workshop/course is more than one evening, give a description of the content for each session:

8. Books, Documents, Audio-Visual Materials, other resources to be used:

9. Please describe briefly the PROCESS to be followed in this program (i.e. film/discussion/talk/questions OR Personal reflection/Small Group Discussion/Presentation/Work Groups/Home Reading Assignments, etc.):

10. What is the TOTAL NUMBER OF CLOCK HOURS towards youth ministry certification requested for this program?
Clock Hours

To which of the following Areas of Growth will the above total number of clock hours relate?

A. Youth Minister as Adult Believer: Clock Hours

B. Understanding Adolescents: Clock Hours

C. Methodology of Youth Ministry: Clock Hours

D. Message of Youth Ministry: Clock Hours

11. Who is the Contact Person for this program?

Phone Number of Contact Person:

12. Any other comments or information:

The information on this accurately reflects the intended design of this program.

Name of Person Seeking Approval:
Title/Position:
Date:
Parish/School:
Address:
City/Town:
Zip Code:
Email Address: