I am interested in: (Circle all that apply) Children s Ministry Middle School Ministry High School Ministry

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1 This application is to be completed by all Interns at Long Hollow each year. This will help our church family provide a safe and secure environment for all preschool, children, and youth who participate in our ministries. GENERAL INFORMATION Full Name: Today s Date: Maiden Name: Address: City: State: Zip: Date of Birth: Home Phone: Cell Phone: Occupation: Employer: Work Phone: Social Security No.: STATUS (Circle) Single Married In a dating relationship EDUCATION High School: College/Trade School: Year Graduated: Year Graduated: Degree: Other Education: Special Training: I am interested in: (Circle all that apply) Children s Ministry Middle School Ministry High School Ministry College Ministry Hendersonville Campus Gallatin Campus

2 SPIRITUAL HISTORY *(Please type and append). *Write a brief testimony about how and when you became a Christian. PERSONAL BACKGROUND In caring for students, we believe it is our responsibility to seek interns who are able to provide healthy, safe, and nurturing relationships. Please answer the following questions. Any special concerns can be discussed individually with the pastoral staff. 1. Are you using illegal drugs? Yes No 2. Have you ever gone through treatment for alcohol or drug abuse? Yes No 3. If yes, please describe. 4. Do you currently smoke? Yes No 5. Do you currently drink alcohol? Yes No 6. What is your view on drinking alcohol? 7. Have you ever been a victim of any form of child abuse? Yes No 8. If yes, would you like to speak to a counselor or pastor? Yes No 9. Have you ever been accused of, charged with, indicted for or pled guilty to any form of child abuse? Yes No 10. Have you ever been accused of, charged with, indicted for or pled guilty to a felony? Yes No

3 CHURCH INVOLVEMENT 1. Where are you a member of a church? 2. How long have you attended that church? 3. While at college, where do you attend church mostly? 4. Are you a member of this church? Yes No 5. If not, why? 6. When and where were you baptized? Please type and append your responses to the following questions # *List the date and activities of other ministry experiences and the reasons for ending that ministry. (Please type and append). 8. *Describe any other ministry/church experience you have had. (Please type and append). 9. * Why do you want to minister to preschool, children, middle school students, or high school students? Please type and append). 10. * What are some of your expectations of the student ministry staff this summer? (Consider this carefully and be thoughtful in your response. Please type and append)

4 PERSONAL REFERENCES Please list three references, including complete mailing addresses, s, and phone numbers. Please do not list family members or ministerial staff of Long Hollow. Preferably, as one of your references, list a staff person (local college pastor, Sunday School leader, et al.) where you are active in worship. 1) 2) 3) APPLICANT S STATEMENT The information contained in this application is correct to the best of my knowledge. I, the undersigned, authorize references or churches listed in this application to provide information (including opinions) they have regarding my character and fitness for working with students. I release all such references from any liability for furnishing such evaluations, provided they do so in good faith and without malice. I waive any right I may have to inspect references provided on my behalf. Should my application be accepted, I agree to be bound by the bylaws and policies of Long Hollow Baptist Church, and to refrain from any unscriptural conduct in the performance of my services on behalf of the church. I further state that I have carefully read the foregoing release and know the content thereof and I sign this release as my own free act. This is a legally binding agreement which I have read and understand. I understand that the personal information in this application will be help confidential by the fulltime church staff. Signature Date

5 Intern Leadership Covenant It s ultimately important to us that our Interns be Christians who can be trusted by the church staff, parents, children, and youth. Therefore, we ask that you consider the top ten qualifications set forth by the staff of Long Hollow. Please pray through these, check off all of them, and sign it below. 1. Be a believer in Jesus Christ as Lord and Savior and be baptized. 2. Be an involved member of a local Church for at least three months (i.e. attend Worship Services and a Sunday School class where they know your name). 3. Participate in personal Bible Study and regularly attend Worship Services. 4. Maintain a Christian lifestyle of moral and sexual purity and abstain from drinking alcohol. 5. Believe and teach the Bible as God s inspired, inerrant Word. 6. Attend intern meetings and training sessions prior to and during the internship. 7. Support Student Ministry and Church Staff in word, deed, and attitude by being respectful, helpful, and dutiful in the scope of your responsibilities. 8. Complete the Intern application process, including group interviews if called back, as well as the exit interview at the close of your internship. 9. Consent to a Background Screening. 10. Read The Sweet 16 and agree with its principles and actively use it to guide and govern your work ethic. Signature Date

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