Clergy Continuation Education Application

Step 1 of 2

Name(Required)

First Last

Date of birth

E-mail(Required)

Enter Email Confirm Email

Registered number of your charity

Home address(Required)

Street Address Address Line 2 City Province Postal Code

Mailing address

Same as a Home address

Street Address Address Line 2 City Province Postal Code

Home Phone #

Mobile Phone #

Name of post secondary institution currently attending or accepted into(Required)

Program(Required)

Year of study(Required)

Parish membership

Parish(Required)

Type of membership:(Required)

Family

Personal

Priest(Required)

Priest’s telephone number(Required)

Personal information of the applicants collected during the application process will be stored in compliance with the Privacy Act in Ukrainian Orthodox Church of Canada Foundation archives for three years.

Name(Required)

First Last

Signature(Required)

Date(Required)