Upper NY Annual Conference Board of Ministry
Application for Psychological Assessment
Check one: This is my initial psychological evaluation for ministry ______
or This is a subsequent psychological evaluation for ministry ______*
*Please note: There is an additional fee of $20 for the testing packet for every subsequent evaluation. This fee is requested at the time the test packet is ordered.
Candidate’s Name: ______
Mailing Address: ______
Phone No(s) home______church______cell______
email: ______
District: ______Local Church: ______
I am anticipating my DCOM Certification Interview on or about (date): ______
Mentor’s Name: ______
Mailing Address: ______
Phone No(s) home ______church______cell______
email: ______
To the Candidate:
In applying for this assessment, I understand that the reports will be available to me and that they will be reviewed with me by a clinical interviewer. I also understand that all materials will remain the property of the Upper New York Annual Conference.
Candidate’s Signature: ______date:______
To the Mentor:
I have discussed the Psychological Assessment process with this candidate and believe s/he is ready for this step. I understand that the evaluation instruments will be sent to me and I agree to monitor the candidate’s completion of them or arrange another suitable monitor.
Mentor’s Signature: ______date:______
In order for this request to be processed, a check must accompany this application.
Make the check of $300 payable to “Upper New York (UNY) Annual Conference”
Send this application and check to the Psychological Assessment Officer of the Board of Ministry:
Rev Pam Mikel Hayes, 264 North Grand Street, Cobleskill, NY 12043
home: (518) 823-4346 church: (518) 234-3671
(Form updated 10/2013)
New York Annual Conference Board Of Ministry
Psychological Assessment Procedure
The Upper NY Annual Conference has entered into an agreement with Clergy Assessment Services to provide the psychological assessments required by The Book of Discipline paragraph 311.2.b. for a candidate for ministry to become certified.
This process will include a battery of tests to be taken by the candidate with the mentor (or another monitor approved by the mentor), several personal references (on Clergy Assessment’s form), and a debriefing interview with a Ministerial Assessment Specialist -- an approved clinical interviewer in your region of our conference. The process can take up to four months. The most common issue
delaying the scoring of the package of materials is that the references have not been timely in returning their forms to Clergy Assessment Services. Therefore candidates are encouraged to follow up with their chosen references within a couple of weeks of the time when they submit their packets.
The contact person for all Psychological Assessment questions in the Upper NY Annual Conference is:
Rev. Pam Mikel Hayes
264 North Grand Street,
Cobleskill, New York 12043
Home phone: 518 823-4346 church phone: 518 234-3671
PROCEDURES FOR OBTAINING THE REQUIRED PSYCHOLOGICAL ASSESSMENT PACKET
1. When both candidate and mentor agree the time is right, AND at least 90 days prior to the scheduled meeting with the District Committee on Ordained Ministry (DCOM) at which time the candidate is requesting Certified Candidate status, you must accomplish 2 tasks:
a. Order the packet. The mentor, using the online OCAS candidacy system, requests a packet of tests to be sent to the mentor’s address.
b. Download the “Psychological Assessment Application” form from the annual conference website (unyumc.org). On the UNYUMC homepage, click on “forms” and type “Psychological Assessment” into the browser box. Download the form and print it out.
2. Complete the Psychological Assessment Application form including signatures of both the mentor and the candidate. Mail the application along with a check for $300 to the Psychological Assessment Officer:
Rev. Pam Mikel Hayes, 264 N Grand Street, Cobleskill, NY 12043.
Your $300 check pays one half of the cost of the assessment with the conference Board Of Ministry paying the other half. You are encouraged to ask your home church to help with this cost, especially if it might present a hardship for you. The process is not considered complete until your payment for ½ the total fee ($300) is received by BOM.
Make check payable to “Upper New York Annual Conference”
3. Your testing materials will be sent to your mentor who will contact you when s/he receives them to schedule a time for you to complete them. At that time, you will also be given several envelopes to address so that Clergy Assessment Service can supply reference questionnaires to specific categories of people who know you in differing settings. This material is a critical part of the whole assessment process.
(1 of 2 revised 10/2013)
4. Your mentor (or other testing monitor) will return the materials to Clergy Assessment Services and once your references have returned their completed forms, all will be reviewed and a report written and supplied to the regional clinical interviewer, MAS, Ministerial Assessment Specialist. You will then be contacted to make an appointment to review and respond to the results.
5. Following your meeting with the clinical interviewer (MAS), your results will be forwarded to the Psychological Assessment Officer for BOM and the chairperson of your District Committee on Ordained Ministry for their use in evaluating you for Certified Candidate status. The report will remain in your DCOM file for later transfer to Board of Ordained Ministry if you pursue commissioning and ordination.
If more than 5 years lapse before commissioning or ordination you will be required to update the Psychological Assessment. This 5 year limitation is the time period between the date of your previous psychological assessment and the date that your materials are due as application to the BOM for commissioning or elders orders.
Please note that there is a $20 fee charged by GBHEM when the subsequent retesting packet is ordered. This is a separate charge from your cost for the evaluation which is $300.
(2 of 2 revised 10/2013)