Certificate Enrollment Form

Name*
First Last
Gender*
Ethnicity*
Date of Birth (MM-DD-Year)*
Religious Affiliation*
Will be used for government reporting only.
Social Security Number*
Email*
Phone*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Certificate Program*
- Certificate in Multireligious Studies
- Certificate in Unitarian Universalist Studies
- Both
How did you hear about us?*
Educational Institutions: (Please include the name of the institution, degree type and date of graduation.)*
Spiritual Institutions or Faith Communities: (Please include some names of groups who have known you.)*
Why are you interested in this Certificate Program at Starr King School for the Ministry, and are you preparing for a specific credentialing process, Chaplaincy, Ministerial Fellowshiping, Religious Education Credentialing, etc.?*
What experiences have prepared you towards undertaking of graduate-level work at SKSM?*
What particular areas of this religious study most impassion you? What do you expect to challenge you the most?*
Name
This field is for validation purposes and should be left unchanged.