DIOCESE OF PITTSBURGH RELIGIOUS EDUCATION FOR OUR CATHOLIC FAMILY FUND Application Form PROFESSIONAL DEVELOPMENT SCHOLARSHIP APPLICATION FORM
Application Form Financial Assistance for Professional Development for Religious Educators This scholarship assists religious educators in defraying costs for various, non-higher education/nondiocesan enrichment Catholic programs such as seminars, workshops and forums from outside sources. Professional development must be geared to equip leaders and educators for the religious formation of children and youth. Applicants must serve the Diocese of Pittsburgh as Catechetical Administrators, Youth Ministers, Campus Ministers, Principals, or Catholic School Religion Teachers. Do you swear to complete all information completely, honestly and truthfully? I do. PLEASE PRINT OR TYPE CLEARLY ALL INFORMATION. Name Last First Middle Address Home Telephone Cell Email Name and Address of Parish at Which You Are Registered Professional Development Program (for which you are applying) Name of Professional Development Program Location Date/s Registration Cost Other Expenses (Please itemize with amounts) 2
SERVICE FOR THE RELIGIOUS FORMATION OF CHILDREN OR YOUTH Please give information concerning your ministry to the religious formation of children and youth. I am a: (check all that apply) Parish/School where I serve in the above capacity: Catechetical Administrator Youth Minister Campus Minister Catholic School Principal Catholic School Religion Teacher Please briefly describe your ministry for the religious formation of youth (number of hours/week, responsibilities, type of activities, etc.) OTHER MINISTRIES OR ACTIVITIES Please indicate any other ministries in which you may be involved Ministry / Activity Parish / School / Institution 3
SACRAMENTAL INFORMATION Baptism If you completed RCIA, in what parish were you fully initiated into the Roman Catholic faith? Date: First Communion Confirmation Marriage EDUCATION College(s)/ University(s) Attended Name City Dates Attended Major Course of Studies Year of College Graduation Undergraduate Degree Completed Post-Graduate Degrees Letters of Recommendation Name City Dates Attended Please attach two letters of recommendation from: 1) your pastor or religious superior verifying that you are registered parishioner / community member and a Catholic in good standing, 2) an individual who can speak to your potential for ministry (a DRE, principal, other leader in ministry, colleague, etc.). Please include the contact information for each below. Name: Address: Phone: Name: Address: Phone: 4
ESSAY Please attach an essay detailing why you would like to attend this Professional Development and how this training will benefit your ministry for the religious formation of children or youth. Please also include an explanation of your financial need. The essay should not exceed 500 words. Signature Date RETURN TO: DEPARTMENT OF FAMILY, YOUTH AND CATHOLIC SCHOOL MINISTRIES ATTENTION: CHRISTINE RADCLIFFE DIOCESE OF PITTSBURGH 2900 NOBLESTOWN ROAD PITTSBURGH, PA 15205-4227 5