Lewis Fellows Application 2020

The Lewis Fellow Program provides an intensive post-graduate leadership development opportunity for young clergy conducted in a cohort setting.

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* 1. Your name as you prefer it to appear in print:

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* 2. Name you prefer to be called by colleagues:

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* 3. Email address:

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* 4. Your Denomination:

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* 5. Your clergy status: (ordained, comissioned, etc...)

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* 6. Your current congregation(s):

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* 7. Position Title:

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* 8. How long have you served in this setting?

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* 9. Date of birth:

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* 10. Race/Ethnicity

Native American/American Indian/Alaskan Native

African American/Black

Asian or Pacific Islander

Causcasian/White

Hispanic/Latino

Multi-Racial

Other (please specify)

Lewis Fellows Application 2020

Lewis Fellows Application 2020

Question Title

* 1. Your name as you prefer it to appear in print:

Question Title

* 2. Name you prefer to be called by colleagues:

Question Title

* 3. Email address:

Question Title

* 4. Your Denomination:

Question Title

* 5. Your clergy status: (ordained, comissioned, etc...)

Question Title

* 6. Your current congregation(s):

Question Title

* 7. Position Title:

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* 8. How long have you served in this setting?

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* 9. Date of birth:

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* 10. Race/Ethnicity

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* 11. Preferred mailing address:

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* 12. Preferred telephone number: (indicate if work, cell, home, other)

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* 13. Optional second telephone number: (indicate if work, cell, home, other)