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* 1. Check one:

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* 2. Name

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* 3. Address

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* 4. Email address

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* 5. Phone number

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* 6. How long have you been a member of Mountain States Mennonite Conference?

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* 7. Which conference church are you a member of?

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* 8. What is your credential status in MSMC?

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* 9. Training Institution(s)

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* 10. Year of completion

Date

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* 11. Years of experience, including any lapses

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* 12. What type of retreats have you led?

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* 13. Describe your approach to Spiritual Direction / Pastoral Counseling

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* 14. How often do you meet with your own Spiritual director and Spiritual direction peer group?

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* 15. What professional organization (s) are you a member of?

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* 16. By entering my name below, I agree to abide by the Code of Ethics established by my professional organization and complete the Annual Accountability expectations of Mountain States Mennonite Conference. 

Updated 09/2020 - Katie Cunningham, Ministerial Council Chair
Resolution approved at MSMC delegate assembly, July 25, 2020

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