Application and Instructions for CPE

Please complete the following to apply to HealthCare Chaplaincy Network's CPE program. The information that you provide us online is secure.

Please note that CPE units offered by HealthCare Chaplaincy are ONLY offered in NY.

Stars indicate required fields.

If you have questions, please contact the CPE Registrar at

HealthCare Chaplaincy Network seeks to draw students from all racial and ethnic groups in our society. Please indicate any identities in which you would include yourself. Any disclosure of ethnic background is completely voluntary and optional, and omitting or providing answers will not affect consideration of your application. The information is used solely for compliance with civil rights laws. HealthCare Chaplaincy Network does not discriminate in its admissions decisions on the basis of race, color, religion, gender, sexual orientation, national origin, age, marital status, or disability.


A denominational, academic and personal reference is required for admission. You may substitute a professional reference if necessary. Please send the following link to three reference givers:

Click for Online Reference form for Clinical Pastoral Education

Preferred Placement

If you have a preference in location, institution, or supervisor, please indicate here.  Also if there is any additional information concerning your placement, please note here.


It is advised that you compose and save your responses in a word document, and then copy and paste them into the online form.  You may also email a Word or PDF file directly to the Registrar at

A Reasonably Full Account of Your Life

Include, for example, significant and important persons and events, especially as they have impacted, or continue to impact, your personal growth and development. Describe your family of origin, current family relationships, and important and supportive social relationships.

The applicant is expected to reflect on her/his life by writing 3 to 5 pages, approximately 2000-3000 words in length.

A Description of Your Spiritual Growth and Development

Include, for example, the faith heritage into which you were born and describe and explain any subsequent, personal conversions, your call to ministry, religious experiences, and significant persons and events that have impacted, or continue to impact, your spiritual growth and development. (1-2 pages requested)

A Description of Your Work (Vocational) History

Include a chronological list of jobs/positions/dates of employment and a brief statement about your current employment and work relationships. A current resume/CV is acceptable.

An Account of a “Helping Incident” in Which You Were the Person Who Provided the Help

Include the nature and extent of the request, your assessment of the issue(s), problem(s), situation(s). Describe how you came to be involved and what you did. Give a brief, evaluative commentary on what you did and how you believe you were able to help. If you have had prior and recent CPE, please attach a copy of a recent verbatim as your 'helping incident' and add to the verbatim your own notes on how and what you learned from sharing this verbatim with your supervisor and/or peers. If you have had CPE, but it was more than two years ago, include a recent account of a helping incident, written up in a verbatim format. If possible, include feedback from current pastoral colleagues and/or administrative supervisor.

Your Impressions of Clinical Pastoral Education. Indicate, for Example, What You Believe or Imagine CPE to Be

Indicate if CPE is being required of you. Indicate any learning goals or issues of which you are aware and would like to address in CPE. Finally, indicate how CPE may be able to help you meet needs generated by your ministry or call to ministry. If you have had prior CPE, please indicate the most significant learning experience you had during CPE. State how you have continued to use the clinical method since your previous experience. Indicate strengths and weaknesses that you have as they relate to your ministry and your identity as a professional person. Indicate any personal and/or professional learning goals and issues that you have at this time and how you believe that CPE will help you to attain or address these learning goals and issues.

If you are an international applicant, you will have to obtain appropriate documentation from U.S. Immigration, which usually implies a visa and a US Social Security Number. Therefore, international applicants should have such documentation approved at least six (6) months prior to the start of the program to which they are applying.  If offered enrollment, can you submit verification of your legal right to work in the U.S.?

Application Fee and Tuition

First-time students, please pay the $75 application fee. Information on payment is available at the end of this application process.

Please note: Tuition is $950. An applicant with prior CPE should email the registrar with all previous self and supervisory evaluations. In addition your signature below indicates you give permission for your previous CPE centers to release your evaluations for purposes of this application process.

You are required to complete an admissions interview with an ICPT supervisor approved by HealthCare Chaplaincy Network. Once your application and fee are received, HCCN’s Registrar will contact you to arrange an interview.

I certify that all information in this application is factually true, complete, and honestly presented. I understand that I may be subject to disciplinary action, including admission revocation or program expulsion, should the information I have certified be false. I hereby give permission to HealthCare Chaplaincy to which I am applying to access my CPE evaluations and contact previous supervisory personnel about matters pertaining to this current application, and I consent for those contacted to provide the information sought. I am aware that my application materials will be read by professionals involved in the admission process in addition to a Clinical Pastoral Education supervisor. I verify that in sending this application electronically it constitutes my electronic signature.

HealthCare Chaplaincy Network is accredited by the Institute of Clinical Pastoral Training (ICPT), a Candidate for Accreditation by the U.S. Department of Education (DOE).