Application for Board Certified CPE Supervisor

Requirements for CPE Supervisor Credential

Please note the application requires a non-refundable fee ranging from $225-$300 US Dollars for the certification and membership fee and an application fee ($50 non-refundable).

Please download the form and complete it.

IMPORTANT: Before you get started, you must collect several supporting documents as noted below.

  • Education: Notarized copies of University/Seminary diplomas
  • Completed WSHO Ecclesiastical Verification Form from Religious/Spiritual Endorsing Authority
  • Current copy of your Resume
  • Signed WSHO Professional Oath
  • Three (3) Character References/Letters of Recommendation, of which one must be from the site administrator/CEL, where you serve and which must be written, signed and dated on the official letter-head paper of the recommending organization
  • Write a statement about what you consider to constitute (1. Spiritual Health (2. Emotional Wellness (3. Love (4. Effective ministry in a inter-faith, religious diverse and multi-cultural environment
  • Write an essay (1 page or less) regarding the integration of personal Character and professional competence
  • Write a 1 page essay describing how you personally and professionally live the WSHO Mission Statement about Spirituality
  • Write a statement describing what you perceive as effective teaching, supervising, and leading small groups
  • Write a 2-3 page Religious/Spiritual autobiography describing your spiritual journey to this point in your life
  • If you have completed any units of Clinical Pastoral Education (CPE) provide copy of Supervisor’s Final Evaluation
  • If you already have a Chaplain certification from a different certifying entity and are requesting reciprocity please submit a notarized copy of your certification.
  • Copy of your Theory/Position Papers (minimum 8 pages each) regarding:
    1. Personality Theory
    2. Education & Supervision Theory
    3. Group Dynamics
    4. Integration of Spirituality and Behavioral Science
  • For Master Board Certification Only: documented evidence of:
    1. minimum of 7 continuous years of providing Clinical Pastoral Education
    2. leadership and professional achievement in a minimum of three of the following areas:
      • Teaching
      • Publication
      • Research
      • Contribution to society/church
      • Professional Leadership/Supervision
      • Other (please specify)

Send the documents via e-mail to or mail hard-copies including this application, fees, and requisite attachments to:
WSHO, PO Box 58766, Salt Lake City, UT 84158-8766