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Site Information Form

Note: The approval process may take 7-10 days. You will not be able to log in to the Site Member Center until your application is approved.

Upon approval, your site will receive an e-mail message to confirm your site username and password and to explain how to log in and use the Site Member Center. This message will be sent to the Site E-mail entered below.

*An asterisk indicates a required item.

Site Login Information
*Username: Enter up to 20 characters.
*Password: Enter an alphanumeric password.
*Confirm Password: Enter your password again.
Site Information
Position Status:  for 2013-2014
Site Name:
Denomination:
Street:
Street 2:
City:
State:
Zip:
Phone:
*Site E-mail:

Enter the primary e-mail for contacting your site. Program information will be sent to this e-mail address.
Web Site:

Example: www.ants.edu

Site Description (300 words or less):
(Note: You can compose your text in Word, then copy and paste in text areas.)

Description of Student Involvement (150 words or less):

Description of the Teaching Parish/Site's commitment to the mission of educating ministers (150 words or less):

Does the site meet the stipend expectation?

Yes No

Comments (50 words or less)

Special considerations (for example, transportation, off-site supervisor, denominational requirements of students):


Contact Information
*Last Name:
*First Name:
Title:
Street:
Street2:
City:
State:   Zip:
Phone:
*Email Address: