Guided Ministry Internship Registration

Supervisor Information

Ministry/Organization of Internship *

Supervisor's Name *

First

Last

Supervisor Contact

Supervisor's Email *

Supervisor's Phone *

Best Time to Call

Student Information

Student Name *

First

Last

Student Contact Information

Student's Email *

Student's Phone

Internship Information

List Specific Responsibilities and Tasks *

Proposed Tentative Schedule for Weekly Meetings *

What will these regularly scheduled meetings with your Field Supervisor look like? *

Learning Covenant and Three Internship Goals:

Learning Covenant *

This “Covenant” is a brief paragraph describing your intention and commitment towards this internship. Briefly summarize what you hope to accomplish during this internship.

Goal #1: Outline your first ministry-related goal? What skill or aptitude are you hoping to improve or develop? *

Goal #2: Outline your second ministry-related goal? What skill or aptitude are you hoping to improve or develop? *

Goal #3: Outline your spiritual formation-related goal? In what personal area are you hoping to strengthen or develop spiritually? *

Student Signature *