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Church Application for Supervised Practice of Ministry

(* indicates a required field.)

* 1). Address Line 1
* 2). Address Line 2
3). City
4). State
5). ZIP
6). Email Address
* 7). Phone Number 1
* 8). Phone Number 2
*9). Name of Congregation
*10). Pulpit Minister
11). Years in present position
*12). Brief description of the Church�s ministry and staff
*13). Suggested areas for intern involvement (Describe the kinds of opportunities the student will have to learn and do ministry at your congregation/agency)
*14). Student Characteristics (Comment on the personal characteristics and qualifications you desire in an intern)
*15). Church/Agency Characteristics (Comment on the characteristics that you have to offer an intern)
*16). Financial arrangements
*17). What housing arrangements would you make for the intern?
*18). Time Frame of Internship (Beginning date)
*19). (Ending date)
*20). Hours per week
*21). Supervising Minister
*22). Supervisor�s Characteristics (Comment on what you have to offer as a mentor to an intern. Please discuss why you would like to supervise an intern.)
23). Additional information that will be helpful