1-Year Paid Internship Application

1-Year Paid Internship Application
Name

First NameLast Name
Date of Birth

MonthDayYear
Gender
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
First Choice: Age group you would like to work with
Second Choice: Age group you would like to work with
T-Shirt Size
Interests:
How did you hear about Lifeline or who recommended Lifeline to you?
Please provide any ministry or volunteer experience that you have:
What is the name of the local church you attend?
Provide a brief testimony of how you personally came to know Jesus and your current relationship with Him.
What do you believe are your strengths, spiritual gifts, and abilities?
What ares of your life do you feel you need to grow in?
What do you anticipate getting out of serving at Lifeline?
Do you have any medical conditions, impairments, or disabilities that would hinder you from being able to work to your fullest potential?
Please explain:
Are you currently under psychiatric care or counseling for any conditions?
Please explain:
Have you ever been convicted of a crime or municipal ordinance violation in any federal, state, or municipal court?
Please explain:
Have you ever pled guilty, been found guilty, entered a plea nolo contendere or Alford plea guilt for ANY offense?
Please explain:
Are you, or have you ever been, placed on any local, state, or federal registry for sex offenders?
Please explain:
Additional Comments:
References

Please list 3 references that are not your immediate family members.
Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Relationship
Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Relationship
Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Relationship
Should be Empty:

1-Year Paid Internship Application

References