Request for a Spiritual Companion

Name
Date
Phone Phone - ### - ### ####
Email
I am a/an:

I am a/an: undergraduate student graduate student seminary student faculty/staff
Address (optional) Address (optional)
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Present Faith Tradition
Denomination / Congregation
Reason for request (check all that apply)

Reason for request (check all that apply) Course requirement For personal nurture By recommendation / referral To continue to meet with Spiritual Companion
If continuing to meet with a Spiritual Companion, who is it?
If a course requirement, what course?
Have you ever met with a Spiritual Companion before?

Have you ever met with a Spiritual Companion before? Yes No
If yes, what has been your previous experience with a Spiritual Companion?
What do you desire to receive from meeting with a Spritual Companion?
What do you do now for prayer?
How are you experiencing God at this time?
Describe briefly what you are looking for in a Spiritual Companion.
What are your present questions and concerns about meeting with a Spiritual Companion?
Which options for meeting would best meet your needs? (check as many as desired)

Which options for meeting would best meet your needs? (check as many as desired) meeting in person meeting using Zoom meeting over the phone