GSC Application Form 2024

Global Service Co-Worker Application

Please complete the form below to apply for a position with Global Ministries.
Full Name

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Place of Birth
Current Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email Address
example@example.com
Home Phone Number

Country CodeArea CodePhone Number
Cell Phone Number

Country CodeArea CodePhone Number
Work Phone Number

Country CodeArea CodePhone Number
Gender Note: This question is asked solely for the purpose of identifying appropriate places of service and church partners.

Cisgender MaleCisgender FemaleTransgenderNon-BinaryPrefer Not to Answer
Are you a U. S. citizen?

YesNo
If no, do you have the legal right to obtain employment in the U. S.?

YesNoN/A
What is your primary language?
What other languages do you speak? Please specify level. T=Tourist, Conversational=C, Near Fluent=NF, Fluent=F
Name and Address of a person who can always reach you
Name
Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Country CodeArea CodePhone Number
Availability and Program
Program Preference

Fully Supported Mission Co-worker (3 - 4 year term) - A Fully Supported (salaried) Mission Co-worker is sent when an international partner makes a request for a person to fill a specific need that meets the Critical Presence criteria, finances are available for the appointment, and an appropriate person who can fill the role is found.Global Mission Intern (1 - 3 year term) - The Global Mission Intern program is an intensive leadership development and faith formation program for young adults, ages 21 - 30.Long-term Volunteer (1 year or more) - Long-term Volunteers serve with an international partner who have expressed critical needs.Short-term Volunteer (2 weeks - 1 year) - Short-term Volunteers serve with an international partner who have expressed critical needs.
Desired Length of Service

3 - 4 years2 years6 - 12 months3 - 6 monthsless than 3 monthsSummer service only
Date Available for Service

MonthDayYear
Date
What issues/factors could affect your a) availability and b) your ability to complete the intended term of service?
Assignment
Preferred Position (please select all that apply)

Open to discuss a variety of position/program optionsPhysician, East TimorPhysician, ZimbabweAcademic, PhilippinesAfrica Priority Position (Multiple positions are open with our partners in Africa; more information is available upon request.)
Preferred Area of Service

AfricaEast Asia and the PacificLatin America and the CaribbeanMiddle East and EuropeSouthern AsiaNo Preference
Type of Position

Community Development/AgricultureEducationHealthcareLeadership DevelopmentFaith Formation and Pastoral MinistryPeace, Justice, and Human RightsInterfaith Relations and Conflict ResolutionOther
Church Membership

Service under the auspices of Global Ministries is open to members of Christian Church (Disciples of Christ) and the United Church of Christ congregations or other Christian churches. Compatibility with GM mission objectives is an expectation.
Church Name
Denomination
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Name of Pastor

First NameLast Name
Phone Number

Country CodeArea CodePhone Number
Describe your involvement in the life of this congregation and wider church
Volunteer Service
Describe your involvement in civic or volunteer service
Education
High School
Name
Course or Major
Years Attended
Degree & Date
College or University
Name
Course or Major
Years Attended
Degree & Date
Graduate Study/Seminary
Name
Course or Major
Years Attended
Degree & Date
Business/Trade/Technical or Other Schools
Name
Course or Major
Years Attended
Degree & Date
Other/Continuing Education
Honors/Awards
Employment History
1. Employer
Name
Position
Address
Phone
Dates Employed
Description of Responsibilities
May we contact this employer at this time?

YesNo
2. Employer
Name
Position
Address
Phone
Dates Employed
Description of Responsibilities
May we contact this employer at this time?

YesNo
3. Employer
Name
Position
Address
Phone
Dates Employed
Description of Responsibilities
May we contact this employer at this time?

YesNo
4. Employer
Name
Position
Address
Phone
Dates Employed
Description of Responsibilities
May we contact this employer at this time?

YesNo
Occupation and Skills
Occupation (if student, intended occupation)
Principal job-related skills you possess that may be used in an international context
Other skills or abilities (P-Professional Training; E=Experienced; H=Hobby/non-technical ability)
Job-related Licenses or Certificates / State or Licensing Agency / Expiration Date
Family Information
If you are married, will your spouse be accompanying you?

YesNo
Spouse Name

First NameLast Name
Spouse Citizenship
Please list any dependents
Placement

Placement may be influenced by such factors as finances, housing, educational needs of children or other family or personal issues.
Financial considerations: Do you have particular financial considerations that might influence the type and length of assignment you could accept?
Life situations: Service in international settings may present challenges related to health, environment, climate and security among others. These issues may affect a person’s ability to live and work in a particular setting. Indicate below any concerns you have related to the following:

Diet/ExerciseEnvironmentClimateSecurityAvailability of medicationsOther
If other, please explain
Children’s education (if applicable): If you have or expect to have school age children during your term of service, are you open to:(check all that apply)

Local schools (non-English)Local schools (English)Boarding schoolHomeschooling
Legal Considerations
Has any civil, criminal, or ecclesiastical complaint ever been sustained or brought against you for misconduct (financial, sexual or other)?

YesNo
Have you ever resigned or been terminated from a position for reasons related to sexual misconduct or financial or other misconduct?

YesNo
Have you ever been convicted of, pled guilty to or pleaded “no contest” to any crime, other than minor traffic violations?

YesNo
Are any charges (for any offense, including traffic offenses), civil suits, or judgments outstanding against you?

YesNo
If you responded yes to any legal consideration question, please explain.
References

Provide four names, including: pastor, professional/academic, employer (non-relatives only)
Reference #1

First NameLast Name
Relationship to Applicant
Occupation
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Phone Number

Country CodeArea CodePhone Number
Reference #2

First NameLast Name
Relationship to Applicant
Occupation
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Phone Number

Country CodeArea CodePhone Number
Reference #3

First NameLast Name
Relationship to Applicant
Occupation
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Phone Number

Country CodeArea CodePhone Number
Reference #4

First NameLast Name
Relationship to Applicant
Occupation
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Phone Number

Country CodeArea CodePhone Number
Additional Information
How did you learn about mission opportunities with the Global Ministries? Check all that apply.

PastorFriend/FamilyPrinted materialsMission eventLocal churchGlobal Ministries staffJob boardCollege career office or professorAdvertisementInternet searchOther
Ordained Clergy

NOTE: You need to notify your regional/conference minister that you are in conversation with Global Ministries. We will seek a reference from that office.
Have you notified your conference/region about your application to Global Ministries?

YesNo
Name of Regional/Conference Minister

First NameLast Name
Date of Ordination

MonthDayYear
Date
Location
Ordaining Body
Narrative Section

Please respond to each question with 200 - 500 words.
How has your Christian faith influenced your decision to pursue an overseas church assignment?
Please give a statement of your understanding of mission in today’s world and the church’s role in that mission.
What do you see as your gifts and aptitudes which equip you to serve in that mission?
Describe any cross-cultural experiences you have had. What did you learn about your ability to live and work in a cross-cultural context? (If you have had limited cross-cultural experience, describe how you see yourself living and working in a cross-cultural context.)
What other information or considerations to your candidacy do you wish to communicate?
Please Read Carefully Before Signing

1. All information provided on this Mission Personnel Information form is complete and accurate, to the best of my knowledge. 2. Candidates who serve with the Global Ministries (GM) will be expected to understand, respect and support the mission of the GM. 3. Misrepresentation of facts in this Personal Information Request form will disqualify me from further consideration or, if I serve with GM, may be sufficient cause for dismissal. 4. In compliance with Federal laws, all offers of employment are subject to verification of each applicant’s identity and employment authorization. I understand that it will be necessary for me to submit such documents as are required by law to verity my identification and employment authorization. 5. Any position offered to me is contingent upon the satisfactory completion of reference checks and any other checks, physical and psychological testing or examinations as may be requested by GM. 6. I understand that nothing contained in this form, or in the granting of an interview is intended to create a contract between GM and me, either for employment or for the providing of any benefits. No promises regarding employment have been made to me, and I understand that no such promise or guarantee is binding upon GM unless made in writing. 7. GM has my permission to investigate, at its discretion, my past employment history, personal references, and any other information pertinent or relative contained in this Mission Personnel Information form. 8. I fully agree to the statements and conditions listed in 1 through 7 above.
Signature*
Date*

MonthDayYear
Date
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Global Service Co-Worker Application

Availability and Program

Assignment

Church Membership

Volunteer Service

Education

Employment History

Occupation and Skills

Family Information

Placement

Legal Considerations

References

Additional Information

Ordained Clergy

Narrative Section

Please Read Carefully Before Signing