BASIC QUESTIONNAIRE FOR PRIMARY CLASS INSTRUCTION

The Manual of The Mother Church requires a teacher of Christian Science to uphold certain standards in the selection of pupils. (Article XXVI). For that reason, it is helpful for the teacher to learn of the pupil’s experience in study and application of this teaching. Your answers to the following questions will be held confidential.

I HEREBY MAKE APPLICATION FOR

PRIMARY CLASS INSTRUCTION IN CHRISTIAN SCIENCE FROM

CHRISTINE JENKS DRIESSEN

1.Name:______Date: ______

2.Street Address:______

3.City: ______

4.State: ______Zip Code:______Country:______

5.Phone: ( ) ______Fax: ( ) ______

6.Cell: ( ) ______E-Mail: ______

7. Are you over 18 years of age? ______. Parental permission required under 18.

8. Are you married? ______

8.Are you a member of any religious faith?______

Which?______

9.What is the condition of your health? Are you taking any medication?

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10.What prompted your desire to consider class instruction?

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11.What led you to the study of Science and Health with Key to the Scriptures, by Mary Baker Eddy?

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12.Are you familiar with the discoverer of Christian Science, Mary Baker Eddy, and if so, what do you feel is her role in bringing Christian Science to the world?

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13.Have you had any healings using the scientific system of healing that Mary Baker Eddy teaches in her textbook, Science and Health? Could you give an example and how you prayed?

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13.“Christian Scientist” refers to a student of this scientific system of healing as taught and practiced by Christ Jesus, his disciples and the prophets (transcending religious denomination). However Mrs. Eddy said that we are not truly Christian Scientists unless we are healing other people beside ourselves. “It is too selfish to pray only for oneself. God does not bless it.” Are you keeping your thought open to the possibility of the public practice of spiritual healing?

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14.Mrs. Eddy writes in Science and Health, “No intellectual proficiency is requisite in the learner, but sound morals are most desirable.” (x:30). How do you define morals?

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15.Please give names, addresses and phone numbers of two Christian Science references, but do not tell them:

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16.Signature: ______

The Church Manual requires a fee of $100 for the two week class, which should accompany

your application in order to secure your place in this year’s class.

PHOTO: I would also like to have a recent photo of you, which you can send either

digitally or by post office. You may return this form through the post office or by e-mail (), but if by e-mail, please also send a hard copy with your signature.

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PLEASE SEND THIS APPLICATION BACK WITHIN TWO WEEKS:

Christine Driessen, CSB, PO BOX 2017, Hyde Park NY 12538