Con Ed - CIP

 
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Please complete the following form by filling in all fields. Additional comments not required.
CONTACT INFORMATION
SUPERVISOR
Day and Time of Weekly Supervisory Meeting
LAY INTERN COMMITTEE
PERIOD OF INTERNSHIP
CONGREGATION'S FINANCIAL COMMITTMENT
Note: The ELCA requires congregations to pay 50% of the student's medical insurance, approximately $1,250.00.
Additional comments, details or circumstances:
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