church_application

Church Name:

Has your church already selected a student to serve as intern? If so, please enter his or her name:

Phone:

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Church Address:

Pastor Name:

Pastor E-mail:

Pastor Phone:

() -

College Attended by Pastor:

Seminary Attended by Pastor:

Other Education by Pastor:

Marital Status of Pastor:

Number of and ages of pastor's children:

Has the pastor previously supervised staff members?:

YesNo

Has the pastor previously supervised college students?:

YesNo

Has the pastor had training in supervision?:

YesNo

If yes, what type? (200 character maximum):

Number of weeks will the pastor be away from church during summer:

Name of supervisor while the pastor is away:

Does the pastor commit to have at least weekly scheduled supervisory sessions with the college intern?:

YesNo

Please provide a detailed church description (1,500 character maximum):

Would your church be willing to accept a student who has had no previous church staff experience?:

YesNoMaybe

If the student owns a car, would you prefer him/her to use it and be reimbursed for expenses?:

YesNo

If the student does not own a car, what type of transportation will be provided?:

What is the age limit for drivers on your church vehicle insurance policy?:

Please provide a description of the ideal student your church is seeking (1,500 character maximum):

Description of living arrangements (750 character maximum):

Describe privacy student will have (300 character maximum):

Will housing arrangements determine whether you should have either male or female student?:

Describe arrangement for meals (e.g. student will provide, host family provides, etc.):

If housing will be provided by host family, please provide the name of the adults in the family and any children (if applicable) and their ages:

Mailing address of host family:

Work and home phone numbers of host family:

Will you be able to provide the student with at least a $600 stipend in addition to the CBF $600 stipend?:

YesNo

Will you be able to provide for the student’s ministry expenses (i.e. camp fees, church-related travel, etc.) during the summer?:

YesNo

Please provide a brief statement of why your church desires to have a Collegiate Congregational Intern (750 character maximum):

Please designate three specific goals you would hope to accomplish during the summer (750 character maximum):

By submitting this application, our church acknowledges that representatives have read/agreed to the expectations agreement at the top of the page and commit to being a congregation through which a summer intern can serve and grow. Please enter pastor's name and the name of two other church leaders/representatives (e.g. personnel committee chair, deacon chair, etc.):