Application to be a recognised Professional Pastoral Supervisor who is recognised by the Baptist Union of Victoria (BUV)

Phone

Email

I have completed my Graduate certificate, diploma or master in professional or pastoral supervision

YesNo

I was awarded (eg Grad Cert, Diploma etc.)

Year of completion…

Name of University or College

I have completed a Bachelor of Theology or Ministry or equivalent (e.g. undergraduate degree in Counselling, Psychotherapy, Psychology, Social Work, Social Science or equivalent)

YesNo

My undergraduate degree was

I have had at least five years of pastoral ministry experience (might include churches, counselling, or community services).

YesNo

My main experience has been

I am currently being supervised by a Professional Pastoral Supervisor.

YesNo

My Professional Pastoral Supervisor's name is

The date of my last session was

I am a member of a recognised body of Professional Pastoral Supervisors.

YesNo

The body I belong to is

I have insurance which covers my practice as a Professional Pastoral Supervisor

YesNo

Insurer details

Are you a part of a Christian Community of Faith

YesNo

If yes, which community?

I agree to provide non identifiable feedback regarding the broad topics discussed in each session. For example: * Person (how who they are affects their work) * System (how the church or ministry is impacting work) * Context (how the broader context is affecting work) * Source (how pastors faith, sense of God is affecting their work)

YesNo

I give permission for the BUV to receive feedback from those I supervise regarding my supervision.

YesNo

I have read the BUV Code of Ethics and agree to encourage pastors to practice their ministry within the requirements of the Code of Ethics.

YesNo

I give BUV permission to place my name and email address on the website. If yes and your application has been approved you will be added to the BUV Supervision page under "Click here to find a recognised BUV Professional Pastoral Supervisor"

YesNo

Please provide what you would like to appear in your profile (no more than 100 words) For example see BUV Supervision page under "Click here to find a recognised BUV Professional Pastoral Supervisor"

I am able to provide my service through

Online (Teams/ZoomGoogle Chat etc)In person

I am willing to service the following areas of Victoria

I have attached a photo for use on the BUV website (file size between 1mb-3mb)

I declare that all of the above is true.

Yes

Is there anything else you would like to say about your application?

Arabic	Burmese	Cantonese	Chin - Falam
Chin - Hakha	Chin - Lautu	Chin - Mara	Chin - Matu
Chin - Mizo	Chin - Zo	Chin - Zomi (Tedim)	Chin - Zophei
Chin - Zotong	English	Filipino	Hungarian
Indonesian	Karen	Korean	Mandarin
Persian	Pwo Karen	Romanian	Samoan
Slavic	Slovakian	Spanish	Sri Lankan
Sudanese	Tedim	Vietnamese