Application for Clinical Pastoral Education

Please note the application requires a non-refundable $20 US Dollar fee.

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
  • Current copy of your Resume
  • Three “stories” (one-half to one page each) of important and pivotal events / people / memories in your life. These may be anything of significance, but with special attention to those experiences which triggered life-change for you.
  • A religious autobiography (two to three pages). Include information about faith group/denominational activities as well as an account of your own religious pilgrimage. If you have held leadership positions of any kind in your religious group, describe each one.
  • An account of a time when you helped someone else (half to one full page). Be specific about the need as you understood it, and how you provided help.
  • A statement about why you want Clinical Pastoral Education. If you have specific ideas about what you would like to learn, include them.
  • A paragraph about what LOVE means to you.
  • Write a statement defining what you consider to be “Spiritual Health” and how it might be measured.
  • Write a statement describing what you consider to constitute “Emotional Wellness”.
  • Write a statement describing what you consider to be the difference between Competency and Character, and how these integrate.
  • If you have had previous Clinical Pastoral Education, please include copies of evaluations written by you and by your supervisor(s).
  • To this point in your life journey in what ways have you been wounded; provide a few examples.

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