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)
7
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.
