Home > Leaders > Leaders' Library > Religious Education Credentialing > Renaissance Program > Module Request

Renaissance Module Request Form

Please complete this form if you want to host a Renaissance module at your congregation, district, or other organization. To ensure appropriate publicity, please submit this form at least six months before the module is to be presented.

If your browser is not showing this page as a secure site, you may
switch to our secure server before completing this form.

Your Name:
Your Email:
Module Title:
Start Date:
End Date:
Location:
Address:


District:
Sponsoring Group:
Coordinator Central contact with the Renaissance Program Office at the Unitarian Universalist Association; he or she gathers all pertinent information from the Registrar, Leader, and Co-leader.
Name:
Email:
Address:


Phone (h):
Phone (w):
Registrar
Name:
Email:
Address:


Phone (h):
Phone (w):
Leader
Name:
Email:
Address:


Phone (h):
Phone (w):

Co-Leader
Name:
Email:
Address:


Phone (h):
Phone (w):
Please specify where display materials should be sent:
	Module location
	Coordinator
	Registrar
	Other (please specify):

Please specify where the readers should be sent to:

You will receive an email confirmation of your submittal from the Religious Education Credentialing Director within the next seven days.

For more information contact recredentialing @ uua.org.

Last updated on Tuesday, June 5, 2007.