Application for Fall and Summer CPE

Positions are offered on a space available basis, so we encourage you to call first to check on space availability before submitting your application.

  1. Complete the UVa Application for Clinical Pastoral Education form. You can download the UVa CPE application and Letter of Reference Form to print off and fill in by hand (Adobe Acrobat Reader required), or you can fill out the secure online application form. A link to the form is located on the bottom of this page. If using the online form, please be sure to use the print-friendly version of the form and print a copy before submitting. Sign the form and attach a recent photo. Then send with the following answered questions and the non-refundable $50 processing fee. Make checks payable to: UVAHS Chaplaincy Services and Pastoral Education.
  2. Please answer the following. The integrity of the information provided is essential. In a separate statement give a reasonably full account of your life and personal development up to the present time. Include any information you believe is significant and in particular, cover the following points: early family life, religious development and significant turning points in your life, educational experiences (degree majors, etc.), current family life, and occupational history.
  3. In separate statements, please answer the following questions and provide explanations, if needed.
    • Have you ever been suspended or dismissed from another CPE program? If yes, please explain.
    • Have you ever been convicted of any felony or misdemeanor, excluding non-moving traffice violations? If yes, explain all circumstances surrounding the conviction.
    • Is there anything else we should know about you that has not been covered in these two questions? If so, please explain.
  4. Hours of service and education may be significant at times. Due to this context, comment on your present state of health (physical and emotional). Your comment should reflect answers to two questions in particular. Do you currently suffer from any health or emotional problem that affects or may affect, your ability to perform your duties as an intern in the department? Do you take any medication or drugs, including alcohol or any form of drug, legal or illegal, which may affect your ability to perform your duties as an intern in the department?
  5. Give a statement of your professional goals and your goals for ministry. Include how you expect to utilize clinical pastoral education. Include in this statement your impressions of clinical pastoral education and your reason for making application.
  6. Provide an evaluation of your pastoral experience. If you have not had pastoral experience describe an incident in which you were called to help someone, the nature of the request, your understanding of the request, and how you attempted to help.
  7. If applicable, submit copies of your and your supervisor's evaluations of previous clinical pastoral education.
  8. Applicants may have an Admissions Interview with any CPE Supervisor or other qualified person (CPE Supervisors, Seminary Liaison Professors, and ACPE Regional Directors may recommend interviewers).
  9. For current UVa/Lynchburg CPE Interns: If you choose to reapply for another unit of CPE, you will need to submit a new application. For item #2, please update your personal history to include reflections on this past unit of CPE. Update item #5 with new learning goals, including how you will utilize another unit of CPE. Please be responsible for making your own copies of evaluations.

**Online Applicants**
We need a signed copy of the online application. Please print a copy before pressing the "Submit" button. Procede to Secure Online Application