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Shalom Place


Spiritual Director Application Form

Are you a spiritual director? If so, would you like to be listed in our directory of ministers available to do spiritual direction, consultations and mentoring/coaching through the Internet?

Here's how it works.

  1. Fill out the application below and Submit it. The team at Heartland Center for Spirituality will review your information and decide if we want to list you.
  2. If you are accepted, we will ask you to send us a picture/digital image and a short biographical sketch (100 words or so). You will also be required to pay for your listing, which you may do via credit card on the Internet, or by using a check. Our fee is $30 a quarter, $50.00 for six months, or $100 a year.
  3. After you are listed, we will forward to you all applications from prospective directees who request your services. If you accept the directee, then you're on your own from then on, scheduling appointments and collecting fees as you see fit.
    - For mentoring/coaching referrals, we pay you $30.00 per referral for one hour of time, after which you and the applicant continue as you choose. Click here for more information about how the mentoring process works.
  4. You are more than welcome to use the resources on the web site whether you purchase a listing with us or not. We would welcome any additions to our growing list that you would like to submit.

Name

Street Address or P. O. Box
. . . . . . .(Apartment Number)

City/State-Province/Zip

Phone # (include area code)

Country

E-mail Address

Place of Employment

Web Site URL (if any)

Do you have liability insurance? . . Yes . No

What fee would you charge for a session?

What is your training and experience doing spiritual direction? (answer below)

Other credentials or pertinent information about you (describe below)

Questions or comments you have for the Heartland team (below)

With which of the following are you familiar? (this can help us to match you with directees who have similar interests and backgrounds).

Topic
Am Familiar

Dreamwork

Inner Child

Centering prayer

Focusing

Contemplative sitting

Scripture meditation

Guided Imagery

Eastern Spirituality

Charismatic Renewal

Creation Spirituality

12 Step Spirituality

Feminine Spirituality

Enneagram

Spirituality of the mystics
Other areas of familiarity

Do you want to be listed as available for short-term consultations?

Yes. No.