Urban Intern Application

NYSUM Urban Internship

Who should apply? A born-again, committed, mature Christian, 18yrs. old or older, who is out of high school, and who is looking to serve wholeheartedly in ministry.
What season are you applying for?*
Name*

First NameLast Name
Do you have work permit?*
Present Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*
Phone Number Type*
Email*
example@example.com
Date of Birth*

MonthDayYear
Date
Marital Status: blanks*
Emergency Contact Name*

First NameLast Name
Emergency Contact Relationship to the Applicant*
Emergency Contact Phone Number *
Emergency Contact Phone Number Type*
Highest Level of Education*
Name of College Attended: blanks # of Years blank
Field of Study:blanks
Special Interests / Hobbies
Special Talents (i.e. piano, arts, singer, etc.)
Do you have any prior work experience? If "yes", please explain. *
Most Recent Employer: blanks Supervisor: blank
Employer Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Employer Phone Number
Ability to Perform Job Duties: This position may involve responsibilities such as ministry outreach, interacting with the public, and occasional physical activity (walking long distances, standing for extended periods of time, climbing subway stairs, lifting supplies, etc.). Are you able to perform the essential functions of this position, with or without reasonable accommodation?*
If "No", please explain: blanks
Church Name: blanks* Years Attended: blank*
Church Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Church Phone Number*
Pastor: blanks* (A "Pastoral Reference Form" must be included with this application, when submitting it to NYSUM. See instruction below.)
How did you become a Christian, and describe what God has been doing in your life since then?*
Why do you want to serve at NYSUM?*
What experience have you had in community living, other than home?*
Evaluate your personal strengths and weaknesses*
Do you have any experience in leadership positions? If "yes", please explain.*
What are your expectations as a staff member?*
Have you ever been convicted for child abuse or a crime involving actual or attempted sexual molestation? (If you prefer, you may discuss your answer with the President personally).*
Doctrinal Statement

WE BELIEVE: The Bible to be the inspired Word of God. In the Triune Godhead. In the deity of Jesus Christ. In the Evangelistic fervor and endeavor. That regeneration by the Holy Spirit is essential to Salvation. In the baptism of the Holy Spirit and His continuing ministry through charismatic gifts. In Christ's imminent personal return.
The information contained in this application is correct to the best of my knowledge. I authorize any references or churches listed in this application to give you any information *(including options) that they may have regarding my character and fitness for ministry. I release all such references from any liability for furnishing such evaluations to you, provide they do so in good faith and without malice. I waive any right that I may have to inspect references provided on my behalf. Should my application be accepted, I agree to be bound by the policies of NYSUM, submit to the Leadership, and refrain from unscriptural conduct in the performance of my service on behalf of this ministry.
Dates available for interview: blanks*
Date you can arrive at NYSUM to serve: blanks*
Please share the link below with your Pastor/Leader to complete your referral. They will fill out the form confidentially and submit it directly to NYSUM staff for review.

NYSUM Pastoral Reference Form: https://form.jotform.com/252395585516164
Applicant's Signature*
Date*

MonthDayYear
Date
UPLOAD RESUME:

Cancelof
Should be Empty:

NYSUM Urban Internship

Doctrinal Statement