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0
Student.Church Church Application 2022
General Church Information
Church Name
*
Name of person completing form
*
First
Last
Title/church position of person completing form
*
Email address of person completing form
*
Church Phone
*
Church web address
Church Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Swaziland)
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
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Guinea-Bissau
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Mali
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Nigeria
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Panama
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Virgin Islands, U.S.
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Country
Has your church had a Student.Church intern in the past?
*
Yes
No
Don't know
If it was in the past few years, who was the intern?
Internship Supervision
Who will be the intern's supervisor?
*
First
Last
Supervisor's church role/title
*
Supervisor's email
*
Supervisor's phone
*
Has the supervisor previously supervised staff members?
*
Yes
No
Has the supervisor previously supervised student interns?
*
Yes
No
Has the supervisor had training in supervision?
*
Yes
No
How could CBF support the supervisor?
*
How many weeks will the supervisor be away from the church during the summer on vacation or in continuing education?
*
Name of alternate supervisor while the supervisor is away
First
Last
Email address of Alternate Supervisor
Student.Church-Specific Questions
Please provide a statement of why your church desires to have a Student.Church intern.
*
What type of internship is this?
*
In-person only
Virtual only
Combination of both
Have you already been in conversation with someone about serving as an intern?
*
Yes
No
Name of identified intern
First
Last
Email address of identified intern
Phone number of identified intern
What is the nature of your relationship with the student identified to serve as the church's intern?
Please describe why the identified student intern is a good fit for your congregation.
*
Would you like help in identifying an intern through Student.Church communcation channels (i.e. website, campus visits, brochure, social media)?
*
Yes
No
Please write a brief job posting for external communication purposes. Include information about the church's context and the specific ways an intern might contribute to your congregation's ministry.(250 words or 1250 character maximum)
Logistical Questions
If the student needs housing, please describe what the church is able to provide for accommodations.
*
If the student does not own a car, what type of transportation will be provided?
*
Expectations
My church commits to matching the CBF grant of $600 with at least $600 towards the student's stipend.
*
We affirm
My church commits to having our intern complete a full nine weeks of the position and will do so within the time frame of May 26-August 1, 2022.
*
We affirm
My church commits to cover all church-related ministry expenses for the student while on the field. For example, camp fees, job-related mileage reimbursement, etc.
*
We affirm
My church affirms the responsibility of running the student's background check.
*
We affirm
My church affirms its knowledge of and respects the dates of the internship's IN-PERSON orientation (May 24-26, 2022) and debriefing (early August, 2022).
*
We affirm
My church affirms that the supervisor and other needed individuals have read, understood, and agree to the requirements of the Student.Church Internship Guide, including the five internship-specific tasks.
*
We affirm