Certification Registration
This application form must be accompanied by your job description and a letter of support from your congregation’s minister and/or board president.

Questions about the UUAMP Certification program or the application process may be directed to Marie Luna, UUAMP Certification Committee Chair, marie@fvuuf.org

Please make your $250 check payable to "UUA-UUAMP" and mail it to:
Mandi Huizenga
38C Loantaka Way
Madison, NJ 07940

Name *
Your answer
Address *
Your answer
Email Address *
Your answer
Congregational Role *
Your answer
Phone Number *
Your answer
Congregation served *
Your answer
Size of current congregation *
Your answer
Length of time at congregation in your role *
Your answer
Congregation’s growth history *
Your answer
Brief description of membership program *
Your answer
Write a brief bio of yourself. This will help us get to know you. *
Your answer
Why do you want to complete this program? *
Your answer
How would you describe your membership program? Healthy, struggling, bursting with energy, in need of a new vision, etc? *
Your answer
What are your strengths as a membership leader? What areas need improvement? Describe your “potential for excellence in membership ministry”. *
Your answer
You will work with a different advisor for each competency. What kind of supervisory style do you prefer? *
Your answer
What questions do you have about the program? *
Your answer
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