Certificate Program Application – Continuing Education

Certificate Program Information

Choose Your Program(s) *

Early Childhood Director Certificate

Educational Technology Certificate

Principal Credential

Teaching Online Certificate

WELS Chaplain Certificate

WELS Evangelism Certificate

WELS Mentoring and Coaching Certificate

Intended Entrance Date *

Biographical Information

Prefix *

First Name *

Middle Name *

Last Name *

Suffix

If Applicable

Former Name

If Applicable

Preferred Email Address *

Enter Email

Confirm Preferred Email Address *

Confirm Email

Street Address *

City *

State *

Zip Code *

Country *

Birth Date *

Gender *

Preferred Phone Number *

Preferred Phone Type *

Citizenship *

Social Security Number

Resident Number *

Racial or Ethnic Background *

Are you a current Wisconsin Evangelical Lutheran Synod or Evangelical Lutheran Synod member? *

Yes

No

You need to be a current member of a WELS or ELS congregation to apply for this certificate. Please email chaplaincert@wels.net if you have questions.

You need to be a current member of a WELS or ELS congregation to apply for this certificate. Please email continuinged@mlc-wels.edu if you have questions.

Name of WELS/ELS Congregation *

Pastor's Name *

High School Name (Graduated) *

High School CIty/State *

High School Graduation Year *

Call/Employment History *

Please include dates, location, and positions for the last eight years of employment/calls.

WELS Chaplain Certificate

Marital Status *

Name of Spouse

Names and Birth Years of Children

Languages Spoken (other than English)

Military Service *

No

Yes

Branch(es) and Dates of Service

Have you ever been convicted of a felony? *

No

Yes

Explain Your Felony Conviction

Have you ever been convicted of sexual misconduct, physical abuse, or sexual abuse? *

No

Yes

Explain Your Sexual Misconduct, Physical Abuse, or Sexual Abuse Conviction

WELS Chaplain Certificate References

Reference 1 Name *

Reference 1 Relationship to Applicant *

Reference 1 Phone Number *

Reference 1 Email Address *

Reference 1 Mailing Address *

Reference 2 Name *

Reference 2 Relationship to Applicant *

Reference 2 Phone Number *

Reference 2 Email Address

Reference 2 Mailing Address *

Military Service

Dates Served

Branch

VA Number

Higher Education Information

Please include all of the institutions you have taken classes/courses with.

Name of Institution

City/State

Dates (Start - End)

Degree/Certificate Earned

Add Remove

Written Statement

Please select how you want to submit your written statement first.

Submission Type *

Submit Via Form

Upload Written Statement

Written Statement *

As part of the application process you must include with this application a written statement of your goals and expectations for this program. This statement should be between 100 and 200 words in length. You can also upload your written statement as a document.

Upload Written Statement *

Maximum upload size: 102.4MB

Certificate Program Agreement

I state that the information provided in this application is accurate and complete to the best of my knowledge. I acknowledge Martin Luther College Office of Graduate Studies and Continuing Education will seek and require a recommendation from my district president and my circuit pastor, if applicable. I give permission to Martin Luther College Office of Graduate Studies and Continuing Education to contact any of the people I have used as references.

Check to Agree *

I agree

Martin Luther College's Annual Security Report is public safety information about our campus and can be accessed by visiting https://mlc-wels.edu/student-life/annual-security-and fire-report/.

If you are not a WELS pastor, WELS staff minister, or a staff ministry certification student please contact your pastor and ask him to send in a pastor’s recommendation. It can either be emailed to continuinged@mlc-wels.edu or mailed to:
Martin Luther College
ATTN: Office of Continuing Education
1995 Luther Ct.
New Ulm, MN 56073

You need to be a current member of a WELS or ELS congregation to apply for this certificate. Please email continuinged@mlc-wels.edu if you have questions.

You need to be a current member of a WELS or ELS congregation to apply for this certificate. Please email chaplaincert@wels.net if you have questions.