Registration for Supervisory Education Winter 2022 HPC

Please complete the Registration Form for this Supervisory Unit.

Name

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

What Enrolled Unit of Supervisory Study is this (Do not include Watch & Witness nor unenrolled SC Units)?

Highest Degree Earned and What Year Did You Graduate?

What was Your Highest Degree In?

Do You Have a Theological or Ministerial Graduate Degree? If so, when did you graduate?

Are you enrolled with CPEI as a Supervisory Candidate?

If you are not currently enrolled as a Supervisory Candidate with CPEI, you will need to do so. Speak with your Supervisor about how to do this.

I understand that I must also complete CPEI Thinkific or Moodle Modules associated with the Supervisory Unit I am enrolled in and will ask how to do this if I do not know how.

I understand that I only receive CPEI credit for the Supervisory Education Units that I pay tuition (Tuition is $1500/unit) for and that I must take a minimum of 4 paid Supervisory Units. Based on my individual progress, I may be required to participate in more than 4 units.