APPLICATION FOR CERTIFICATION OF PERMANENT DEACONS Please PRINT as you wish your name to appear on your certificate.

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1 ARCHDIOCESE OF SAN ANTONIO CATECHETICAL CENTER 2718 West Woodlawn Avenue San Antonio, Texas FOR OFFICE USE ONLY Received: Fee: Reviewed APPLICATION FOR CERTIFICATION OF PERMANENT DEACONS Please PRINT as you wish your name to appear on your certificate. FULL NAME HOME ADDRESS Street PHONE PARISH/SCHOOL (circle one) City Area Code + Day Zip Area Code + Evening I hereby apply for the following Catechist Certification: Intermediate -or- Advanced (Level 2) (Level 3) I hereby apply for Renewal of Catechist Certification: (When applying for renewal, documentation of ongoing formation must be included in packet.) Level of Last Certification: The following documentation is attached: Readable photocopy of Pagella - or - Letter of Validation from the Diaconate Office Documentation of Level 2 course #221 The Ministry of Catechesis: Theory and Practice -or- an equivalency to this course (Pastoral Catechesis) I have years of successful catechetical experience number Signature of Applicant A $5 application fee must accompany this application. To be included in the annual Archdiocesan appreciation expressed in the Catechetical Sunday issue of Today s Catholic, this application must be submitted by June 30 th. This form replaces all previous versions December 2014 A-2

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3 Documentation is required to support all workshops and courses taken. PERMANENT DEACON Level 2 / 3 Formation Page FULL NAME DATE PARISH/SCHOOL I DEACON FORMATION PROGRAM FOR INTERMEDIATE (LEVEL 2) CERTIFICATION (NOTE: Please send copies of documentation, no originals.) Readable photocopy of Pagella -or- Letter of Validation from Permanent Diaconate Office Documentation of Level 2 course #221 The Ministry of Catechesis: Theory and Practice -or- an equivalency to this course (Pastoral Catechesis) II PRAYER AND RETREAT EXPERIENCES Two Required Type of Experience: Location: Attended: III UPDATING If any of the work listed above was done more than 5 years ago, please supply evidence that you have continued your formation since that time. Continued on Reverse December 2014 B-5

4 Documentation is required to support all workshops and courses taken. IV COMMENTS V Submit this form along with the Application for Certification of Permanent Deacons (A-2) form and application fee. Consult the Certification Process Manual for qualifying criteria for equivalencies. This form replaces all previous versions. December 2014 B-5

5 ARCHDIOCESE OF SAN ANTONIO CATECHETICAL CENTER 2718 West Woodlawn Avenue San Antonio, Texas RECOMMENDATION FOR CATECHIST CERTIFICATION (to be completed by DRE, Principal, Pastor or Catechetical Ministry Supervisor) Each catechist applying for certification needs a written recommendation attesting to competencies as a catechist. Please review this recommendation with the applicant. NAME OF APPLICANT APPLYING FOR CERTIFICATION LEVEL (circle one) Renewal PARISH OR SCHOOL (circle one) YES NO (to be completed by ministry supervisor) Is the applicant active in your parish/school catechetical program Has the applicant had successful experience as a catechist? -1 years for Intermediate Certification -2 years for Advance Certification -3 years for Professional Certification Does this applicant exhibit a familiarity with the cultural reality of the Archdiocese of San Antonio? Please COMMENT on your experience of the applicant s skill and effectiveness as a catechist. I recommend Applicant s Name for certification. Signature of Ministry Supervisor I have read and discussed this completed form with the person recommending me. Applicant s Signature A $5 application fee must accompany this application. To be included in the annual Archdiocesan appreciation expressed in the Catechetical Sunday issue of Today s Catholic, this application must be submitted by June 30th. This form replaces all previous versions October 2014 A-4

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