internship application


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565 Airport Road New Holland, PA 17557 717-354-5394 www.petra.church

INTERNSHIP APPLICATION N e w

Application Date: _____/_____/______

H o All information shared in this application is completely confidential and will only be seen by Petra Church l leaders connected with this internship. If you have any questions about this application, please call 717-354l 5394, ext. 118, or email [email protected] a n GENERAL INFORMATION d ,

Last Name:

Please attach a recent photograph of yourself here. (Any size.) P

First Name:

Preferred Name:

A

Address:

1 7 5 5 7

City:

State:

Phone:

Email:

Birth date*: __/__/____

Zip:

Gender: __Male __ Female

*(If you are under 18 years of age, please have a parent/guardian fill out a release form)

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1 Place of Birth: _____________________________ Nationality: __________________________ 7 Marital Status: __Single __ Dating __ Engaged __ Married __ Widowed __ Separated __ Divorced__ Remarried 3 5 Name of spouse or fiancé: ________________________ Date of marriage (if engaged): ________ 4 5 3 9 EDUCATION: INTERNSHIP MODULE: 4 Highest Level of Education completed: __ High School Diploma __ Associates __ Bachelors __ Masters List any degrees you have obtained, and your major:

List any trade schools, professional schools, or vocational schools you attended:

Which internship module are you interested in pursuing? w w w __ Worship Arts Ministry . p __ Care Ministry e __ Student Ministries t r __ Children’s Ministry a __ Connections and Discipleship. c __ Missions h u r c h __ General Pastoral Ministry

565 Airport Road New Holland, PA 17557 717-354-5394 www.petra.church

INTERNSHIP APPLICATION N e w

EMPLOYMENT:

Company Name: __________________________________________ Starting Date: __/__/____ H o Location: _______________________________________ Role/Title: _____________________ l l a n SPIRITUAL LIFE: d , Home Congregation: _____________________________ Pastor’s Name:___________________ P Church Phone: ___________________ Are you a member? __Yes __ No A How long have you attended? ____________ How long have you been a Christian? _________

1 7 What spiritual gifts do you see at work in your life? (Evangelism, serving, prophetic ministry, teaching, etc.): 5 __________________________________________________________________________ 5 7 Describe your current walk with the Lord: ___________________________________________ 7 ______________________________________________________________________________ Please try to assess yourself on the following: Spiritual Maturity ---------------------Devotion to Christ --------------------Personal Integrity/Honesty---------Self-Discipline--------------------------Willingness to Serve------------------Teachability-----------------------------Flexibility--------------------------------Ability to Work with Others --------Family Life ------------------------------Communication Skills ----------------Leadership Skills ----------------------Reliability--------------------------------Physical Health-------------------------Emotional Stability--------------------Openness to Correction -------------Attitude Toward Authority-----------

__ Weak __ Weak __ Weak __ Weak __ Weak __ Weak __ Weak __ Weak __ Weak __ Weak __ Weak __ Weak __ Weak __ Weak __ Weak __ Weak

__ Fair __ Fair __ Fair __ Fair __ Fair __ Fair __ Fair __ Fair __ Fair __ Fair __ Fair __ Fair __ Fair __ Fair __ Fair __ Fair

__ Good __ Good __ Good __ Good __ Good __ Good __ Good __ Good __ Good __ Good __ Good __ Good __ Good __ Good __ Good __ Good

__ Very Good __ Very Good __ Very Good __ Very Good __ Very Good __ Very Good __ Very Good __ Very Good __ Very Good __ Very Good __ Very Good w __ Very Good __ Very Good __ Very Good __ Very Good __ Very Good

1 7 3 5 4 5 3 9 4

w w . p e t Comments on any of the above: ___________________________________________________ r a ______________________________________________________________________________ . c h u r c h

565 Airport Road New Holland, PA 17557 717-354-5394 www.petra.church

INTERNSHIP APPLICATION N

What would you consider to be your strengths?

e w

______________________________________________________________________________ H o _________________________________________________________________________ l l What would you consider to be your weaknesses? a n ______________________________________________________________________________ d , ______________________________________________________________________________ P List some of your hobbies and interests: A ______________________________________________________________________________ 1 7 ______________________________________________________________________________ 5 5 What are you hoping to participate in, and what are you hoping to gain from your Petra Internship? 7 ______________________________________________________________________________ 7 1 7 PERSONAL TESTIMONY: On a separate sheet of paper, please type or write a brief personal3 testimony. Include your conversion experience, your experience with the ministry of the Holy Spirit, and your5present walk with God. 4 5 LIFE DIRECTION ESSAY: On a separate sheet of paper, please answer the following three questions. 1. 3 What are your expectations and goals for this internship? 2. Do you have any life goals or plans for your 9 the Lord. future? 3. To the best of your ability, describe any defined personal calling you have received from 4 ______________________________________________________________________________

I have read, understand, and I am in agreement with Petra’s internship Commitment, Petra’s mission and core values, and w Petra’s internship code of conduct.

 Petra Internship Outline and Commitments  Petra Core Values and Mission Statement  Petra Internship Code of Conduct 

Parental Release Form (if you are under 18 years of age)

Signature: _________________________________________________ Date: __/__/ ____

w w . p e t r a . c h u r c h

565 Airport Road New Holland, PA 17557 717-354-5394 www.petra.church

INTERNSHIP APPLICATION N e w H o l l a n d , P A 1 7 5 5 7

(See following page for Pastor Reference)

7 1 7 3 5 4 5 3 9 4

w w w . p e t r a . c h u r c h

565 Airport Road New Holland, PA 17557 717-354-5394 www.petra.church

PASTORAL INTERNSHIP REFERENCE APPLICATION (Applicants from Petra may use a role

N model/mentor as their reference.) e w

I give my permission for ______________________ to complete this confidential PastoralHReference. o

Applicant’s Name _____________________ Signature ________________________ Date l_________

To Be Completed by the Pastor: Your Name:

l a n d ,

Your Position:

Church Name: Address: City:

State:

Church Phone:

Home/Cell Phone:

E-mail:

How long have you known the applicant? __ Years __ Months

Zip:

P A 1 7 5 5 7

How well do you know the applicant? __ Very Well __ Fairly Well __ Casually __7By Name / Sight Only 1 7 How long has he/she attended your congregation? __ Years __ Months Does the applicant’s life express their Christian testimony? __ Yes __ No __ Inconsistently 3 5 What are the strengths and spiritual gifts of the applicant according to your observation? 4 ______________________________________________________________________________________ 5 3 ______________________________________________________________________________________ 9 4 What is your assessment of weaknesses or struggles you have observed in the applicant? ______________________________________________________________________________________ w w ______________________________________________________________________________________ w Considering the applicant’s character, spiritual gifts, and knowledge of the Scriptures, rate (circle) .their p maturity on a scale of 1-10 (10 being most Christ-like): 10 9 8 7 6 5 4 3 2 1 e t Describe the applicant’s level of involvement in your congregation. What areas of ministry does he/she r currently serve in? a . ______________________________________________________________________________________ c ______________________________________________________________________________________ h u r c h

565 Airport Road New Holland, PA 17557 717-354-5394 www.petra.church

Please assess based on your knowledge of the applicant: Spiritual Maturity ---------------------Devotion to Christ --------------------Personal Integrity/Honesty---------Self-Discipline--------------------------Willingness to Serve------------------Teachability-----------------------------Flexibility--------------------------------Ability to Work with Others --------Family Life ------------------------------Communication Skills ----------------Leadership Skills ----------------------Reliability--------------------------------Physical Health-------------------------Emotional Stability--------------------Openness to Correction -------------Attitude Toward Authority-----------

__ Weak __ Weak __ Weak __ Weak __ Weak __ Weak __ Weak __ Weak __ Weak __ Weak __ Weak __ Weak __ Weak __ Weak __ Weak __ Weak

__ Fair __ Fair __ Fair __ Fair __ Fair __ Fair __ Fair __ Fair __ Fair __ Fair __ Fair __ Fair __ Fair __ Fair __ Fair __ Fair

__ Good __ Good __ Good __ Good __ Good __ Good __ Good __ Good __ Good __ Good __ Good __ Good __ Good __ Good __ Good __ Good

PASTORAL INTERNSHIP REFERENCE APPLICATION

(Applicants N from Petra may use a role model/mentor as theirereference.) w

__ Very Good __ Outstanding __ Very Good __ Outstanding __ Very Good __ Outstanding __ Very Good __ Outstanding __ Very Good __ Outstanding __ Very Good __ Outstanding __ Very Good __ Outstanding __ Very Good __ Outstanding __ Very Good __ Outstanding __ Very Good __ Outstanding __ Very Good __ Outstanding __ Very Good __ Outstanding __ Very Good __ Outstanding __ Very Good __ Outstanding __ Very Good __ Outstanding __ Very Good __ Outstanding

(__Uncertain) H (__Uncertain) o (__Uncertain) l (__Uncertain) l (__Uncertain) a (__Uncertain) n (__Uncertain) d (__Uncertain) , (__Uncertain) (__Uncertain) P (__Uncertain) A (__Uncertain) (__Uncertain) 1 (__Uncertain) 7 (__Uncertain) 5 (__Uncertain) 5

7 Comments on any of the above: _____________________________________________________________ 7 _______________________________________________________________________________________ 1 7 How would you recommend this application for Petra’s Internship? __ Highly Recommend __ Recommend __ Recommend with reservations* __ Do not recommend* 3 5 4 *Please explain any concerns:_______________________________________________________________ 5 _______________________________________________________________________________________ 3 9 Please give any other helpful comments: ______________________________________________________ 4 ________________________________________________________________________________________ w w w . Please Please return this form to: Petra Christian Fellowship – Internship, 565 Airport Road, New Holland, PA 17557. p mark the envelope confidential. If you have any questions, you may e-mail: [email protected] or call 717-354-5394. e t r Pastor’s Signature: _________________________________________________ Date: __/__/ ____ a . c h u r c h To the Pastor: Thank you for your recommendation and honesty.