{"id":514,"date":"2022-07-18T13:34:57","date_gmt":"2022-07-18T20:34:57","guid":{"rendered":"https:\/\/depts.washington.edu\/chaplain\/wordpress\/?page_id=514"},"modified":"2022-09-19T16:07:26","modified_gmt":"2022-09-19T23:07:26","slug":"apply-for-intern-unit","status":"publish","type":"page","link":"https:\/\/depts.washington.edu\/chaplain\/clinical-pastoral-education\/apply-online-pay-fees\/submit-application\/apply-for-intern-unit\/","title":{"rendered":"Apply for Intern Unit"},"content":{"rendered":"<script type=\"text\/javascript\">var gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,initializeOnLoaded:function(o){gform.domLoaded&&gform.scriptsLoaded?o():!gform.domLoaded&&gform.scriptsLoaded?window.addEventListener(\"DOMContentLoaded\",o):document.addEventListener(\"gform_main_scripts_loaded\",o)},hooks:{action:{},filter:{}},addAction:function(o,n,r,t){gform.addHook(\"action\",o,n,r,t)},addFilter:function(o,n,r,t){gform.addHook(\"filter\",o,n,r,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,n){gform.removeHook(\"action\",o,n)},removeFilter:function(o,n,r){gform.removeHook(\"filter\",o,n,r)},addHook:function(o,n,r,t,i){null==gform.hooks[o][n]&&(gform.hooks[o][n]=[]);var e=gform.hooks[o][n];null==i&&(i=n+\"_\"+e.length),gform.hooks[o][n].push({tag:i,callable:r,priority:t=null==t?10:t})},doHook:function(n,o,r){var t;if(r=Array.prototype.slice.call(r,1),null!=gform.hooks[n][o]&&((o=gform.hooks[n][o]).sort(function(o,n){return o.priority-n.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==n?t.apply(null,r):r[0]=t.apply(null,r)})),\"filter\"==n)return r[0]},removeHook:function(o,n,t,i){var r;null!=gform.hooks[o][n]&&(r=(r=gform.hooks[o][n]).filter(function(o,n,r){return!!(null!=i&&i!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][n]=r)}});<\/script>\n                <div class='gf_browser_gecko gform_wrapper gravity-theme' id='gform_wrapper_1' style='display:none'>\n                        <div class='gform_heading'>\n                            <h2 class=\"gform_title\">Apply for Intern Unit<\/h2>\n                            <span class='gform_description'><\/span>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_1'  action='\/chaplain\/wp-json\/wp\/v2\/pages\/514' novalidate>\n                        <div class='gform_body gform-body'><div id='gform_fields_1' class='gform_fields top_label form_sublabel_below description_above'><div id=\"field_1_1\"  class=\"gfield gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_1_1\"><label class='gfield_label' for='input_1_1' >Intern Unit<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_1_1'>Indicate only one unit \u2013 your first choice  (e.g. Fall 2024)<\/div><div class='ginput_container ginput_container_text'><input name='input_1' id='input_1_1' type='text' value='' class='large'  aria-describedby=\"gfield_description_1_1\"   aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_1_3\"  class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_1_3\"><label class='gfield_label' for='input_1_3' >Full Legal Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_3' id='input_1_3' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_1_4\"  class=\"gfield gfield--width-full field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_1_4\"><label class='gfield_label' for='input_1_4' >Full Preferred Name<\/label><div class='ginput_container ginput_container_text'><input name='input_4' id='input_1_4' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_1_5\"  class=\"gfield gfield--width-full field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_1_5\"><label class='gfield_label' for='input_1_5' >Pronouns<\/label><div class='ginput_container ginput_container_text'><input name='input_5' id='input_1_5' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_1_6\"  class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_1_6\"><label class='gfield_label' for='input_1_6' >Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_6' id='input_1_6' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_1_7\"  class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_1_7\"><label class='gfield_label' for='input_1_7' >Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_7' id='input_1_7' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_1_15\"  class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_1_15\"><label class='gfield_label' for='input_1_15' >Mailing Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_15' id='input_1_15' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_1_9\"  class=\"gfield gfield--width-full field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_1_9\"><legend class='gfield_label'  >Interested in other Intern Units?<\/legend><div class='gfield_description' id='gfield_description_1_9'>If your preferred Intern Unit is full, are you interested in being considered for other Intern Units? <\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_1_9'>\n\t\t\t<div class='gchoice gchoice_1_9_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='Yes'  id='choice_1_9_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_9_0' id='label_1_9_0'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_9_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='No' checked='checked' id='choice_1_9_1' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_1_9\"   \/>\n\t\t\t\t\t<label for='choice_1_9_1' id='label_1_9_1'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_1_10\"  class=\"gfield gfield--width-full field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_1_10\"><label class='gfield_label' for='input_1_10' >Which alternate Units?<\/label><div class='gfield_description' id='gfield_description_1_10'>Please indicate the alternate units you are open to (e.g. Spring 2025 and Fall 2026)<\/div><div class='ginput_container ginput_container_text'><input name='input_10' id='input_1_10' type='text' value='' class='large'  aria-describedby=\"gfield_description_1_10\"    aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_1_11\"  class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_1_11\"><label class='gfield_label' for='input_1_11' >ACPE Facesheet \/ Application<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='2097152' \/><input name='input_11' id='input_1_11' type='file' class='large' aria-describedby=\"gfield_upload_rules_1_11\" onchange='javascript:gformValidateFileSize( this, 2097152 );'  \/><span class='gform_fileupload_rules' id='gfield_upload_rules_1_11'>Accepted file types: pdf, Max. file size: 2 MB.<\/span><div class='validation_message validation_message--hidden-on-empty' id='live_validation_message_1_11'><\/div><\/div><\/div><div id=\"field_1_12\"  class=\"gfield gfield--width-full field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_1_12\"><label class='gfield_label' for='gform_browse_button_1_12' >ACPE Application Responses<\/label><div class='gfield_description' id='gfield_description_1_12'>Your responses to the list of requirements on the ACPE Application form, compiled into a single document. 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Verbatim with Reflection (see ACPE Application Question #5)\n<br>\n2. Final Self Evaluation* for each previous CPE unit\n<br>\n3. Signed Certified Educator\u2019s Final Evaluation* for each previous CPE unit\n<br>\n*Note:  Mid-Unit Evaluations may be substituted for Final Evaluations if you are a current CPE student who has not yet completed\/received your Final Evaluation(s)<\/div><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_1_13' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_1_13&quot;,&quot;container&quot;:&quot;gform_multifile_upload_1_13&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_1_13&quot;,&quot;filelist&quot;:&quot;gform_preview_1_13&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/depts.washington.edu\\\/chaplain\\\/wordpress\\\/?gf_page=4d7481ebfffa8fe&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/depts.washington.edu\\\/chaplain\\\/wordpress\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/depts.washington.edu\\\/chaplain\\\/wordpress\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;pdf,doc,docx,txt,rtf&quot;}],&quot;max_file_size&quot;:&quot;2097152b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:1,&quot;field_id&quot;:13},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_1_13&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_1_13' class='gform_drop_area'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_1_13' class='button gform_button_select_files' aria-describedby=\"gfield_upload_rules_1_13 gfield_description_1_13\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gform_fileupload_rules' id='gfield_upload_rules_1_13'>Accepted file types: pdf, doc, docx, txt, rtf, Max. file size: 2 MB.<\/span><ul class='validation_message validation_message--hidden-on-empty gfield_validation_message gform-ul-reset' id='gform_multifile_messages_1_13'><\/ul> <!-- Leave <ul> empty to support CSS :empty selector. --><\/div><div id='gform_preview_1_13'><\/div><\/div><fieldset id=\"field_1_14\"  class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_1_14\"><legend class='gfield_label gfield_label_before_complex'  >Application Fee<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_1_14'><div class='gchoice gchoice_1_14_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_14.1' type='checkbox'  value='I will submit the application fee per the instructions on the &lt;a href=&quot;https:\/\/depts.washington.edu\/chaplain\/clinical-pastoral-education\/apply-online-pay-fees\/pay-application-fee\/&quot;&gt;Pay Application Fee&lt;\/a&gt; 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