Please complete this application form if you are interested in becoming a Spiritual Care Partner Volunteer in our Lexington facilities. Once you complete the form, click the Continue button at the bottom.

Contact Information

First name:

Last name:

Street 1:

Street 2:

Street 3:

City:

State:

Zip:

Home phone:

OK to call me here

Work phone:

OK to call me here

Cell phone:

OK to call me here

Email address:

Place of Worship:

Faith Community Member Reference

Reference: Please provide contact information for a faith community member (fellow member, etc.) who knows you well.

First name:

Last name:

Home phone:

OK to call here

Work phone:

OK to call here

Cell phone:

OK to call here

Email address:

Required Pastoral Letter of Endorsement

In order to be considered for the Spiritual Care Partners Volunteer Program, a letter of endorsement from your senior ministry leader is required (senior pastor, priest, rabbi, etc.). This letter needs to attest to two key items:

1. Your good standing as a member in your faith community;

2. Your active engagement in ministry activities in your faith community (serving on committees, teaching Sunday school, assisting with worship services, leading Bible study, serving on mission trips, etc.)

Assessment Questions

Please answer the following questions to the best of your ability.

Question #1

What interests you about the Spiritual Care Partners program and why would you like to participate?

Question #2

What is your religious tradition or denomination?

Question #3

What particular religious or spiritual principles guide your life?

Question #4

What authors, writers, and spiritual leaders have impacted your spiritual life?

Question #5

Please describe a time when you have provided helpful listening to someone who was in emotional distress. Please describe what you did that helpful for this person.

Question #6

What do you hope to get most our of this training and ministry experience?

Question #7

Attendance to all sessions is required in order to graduate. Will you be able to attend every session from mid-September to mid-November, aside from unanticipated changes to your schedule?

I will be able to attend all sessions:

Yes

I agree

I understand attendance to all training sessions is required in order to graduate. I will be able to attend every session from mid-September to mid-November, aside from unanticipated emergencies.

I understand and agree that submitting this application form does not automatically register me as a KentuckyOne Health volunteer, and that there may be certain qualifications I must meet, including the acceptance of established volunteer policies and procedures before I may begin volunteering.

By submitting this form, I attest that the information I have provided on the form is true and accurate. I understand and agree that falsification of this or any other information is grounds for immediate termination.

I Agree