Name

Age

Address

City, state

Postal code

Phone (home)

Phone (cell)

Phone (fax)

E-mail

Endorsing congregation

Region or school

Interns serve at the following locations:

• All Peoples Christian Center;
• Inman Christian Center;
• Yakama Christian Mission;
• Vision Builders Ministry;
• Southwest Good Samaritan Ministries;
• F.A.S.T.

Internships begin with a training event, scheduled May 25 to 30, and conclude August 9. Interns will travel from the training to their summer placement location.

I will   will not have a vehicle on site.

I do   do not speak Spanish.

I have   have not
participated in a Disciples Volunteering Leader Development Work trip.

List two references below. Ask them to complete a reference form and submit it as soon as possible. The form can be found online.

#1 reference

address

city, state

zip code

phone

e-mail

#2 reference

address

city, state

zip code

phone

e-mail

List a pastoral reference below. This would be a third reference. Ask them to complete a reference form and submit it as soon as possible. The form can be found here: www.homelandministries.org/MISSIONS/SpecialProjects/internreference.htm.

#3 reference
(pastoral)

address

city, state

zip code

phone

e-mail

These positions will involve organizing work groups and working with all sorts of people. They will involve a need for flexibility. In some cases, skills in carpentry will be helpful.

The stipend and room and board will vary from site to site but will all reflect that this is a volunteer position.

Please reflect on the following questions and return narratives to each question with your application (it might be helpful to type them in another document then copy and paste them into the appropriate box):

1. Describe an area of your life where you have recently grown in your Christian faith. How did you see God at work in the process?

2. Describe an experience you have had with a person or a group of people from another race or culture. What, if any, impact did that experience have on your life?

3. What has led you to apply for a Homeland Mission Intern position? What skills, knowledge, experience do you see yourself contributing?

4. Describe your experience on participating in or leading worktrips/mission trips/hands on mission experiences.

How did you find out about the interns?

Work History: (list most recent first in this order: dates, employer, address, position/responsibilities)

Health Concerns:
Any health issues that would affect your ability to fulfill the intern’s tasks?

Share any health concerns including medication you are on and past or present health history:

Health/Insurance Information

Do you have health insurance? Yes     No

Hospital/Health Insurance Co.:
Policy #:
Coverage in the name of:

Someone from the Office of Disciples Volunteering will contact you before the first of March.

Questions? Call Brenda Tyler. Members of the Christian Church (Disciples of Christ) will be considered first.