Internship Application

First Name *

Last Name *

Email *

Home Address *

City *

State *

Zip Code *

Permanent Phone *

Drivers License Number *

Birth Date *

mm/dd/yyyy

High School *

Graduation Year *

College Attending *

College Email *

College Address (If different from home)

Street, City, State, Zip

College Major *

GPA *

Year in School *

Why do you want to work with youth and why do you think you would be good at working with youth? *

What previous experience do you have working with youth? *

Explain how you became a Christian. *

What role does God play in your life? *

From your perspective, what is the Bible? *

If you were to stand in front of God and he asked you, "Why should I let you enter heaven?" What answer would you give? *

Name three people who have the greatest impact on your life and why. *

Has your license been revoked or suspended in the last three years? *

• Yes
• No

Have you had any moving violations (tickets other than parking) within the last three years? If yes, how many? *

May we do a background check and/or obtain a copy of your driving record? *

• Yes
• No

Have you ever been arrested or criminally convicted in your life? *

• Yes
• No

If you answered Yes to any of the driver or criminal questions, please explain all instances in detail.

Will you have a car? *

• Yes
• No

Name and Address of the church you are attending. *

What is your participation at church? *

Pastors information *

Name, Phone/email

Person overseeing your involvement at your church and his/her information *

Name, Phone/email