Internship Application - Missions

Please select the internship for which you are applying:*
Applicant Information
Name*
First Middle Last
Date
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Primary Phone*
Email*
Time frame you are interested in serving*
Citizen of the United States?*
- Yes
- No
If no, are you authorized to work in the United States?*
- Yes
- No
Do you have a valid driver's license?
- Yes
- No
State of issue and license #:

Emergency Contact
Relationship
Name*
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Email
Background Information
Are you in agreement with Push The Rock's Vision, Mission and Core Values?*
- Yes
- No
Have you ever traveled or worked internationally?*
- Yes
- No
If so, where and for what purpose?
Have you ever been convicted of a felony?*
- Yes
- No
If yes, please explain.
Church Information
Push The Rock values the partnership with the local church and would like to connect with your church about your interest in the internship.
Church Name*
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Website
Senior Pastor
Senior Pastor Email
Church Leader*
Church Leader Position
Church Leader Email

Health
Do you have any health conditions that require special attention or that would keep you from participating fully in this internship?*
- Yes
- No
If so, what are they?
Does your insurance offer international health coverage?*
- Yes
- No
Insurance Company
Policy #
Education
High School
Address
Street Address City State ZIP Code
Did you graduate?
- Yes
- No
Degree:
Dates Attended
College
Address
Street Address City State ZIP Code
Dates Attended
Did you graduate?
- Yes
- No
Degree

References
Please list three references other than relatives or previous employers.
(1) Name*
First Last
Relationship
Company / Organization
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
(2) Name*
First Last
Relationship
Company / Organization
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
(3) Name*
First Last
Relationship
Company / Organization
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
Sports Related Experience
Please list your involvement with sports that might prove beneficial for this internship.
Sports Ministry Experience
Please list your involvement with sports ministry.

Work Experience (beginning with most recent job)
(1) Company / Organization
Phone
Website
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Responsibilities
Dates of Employment
Reason for Leaving
May we contact your previous supervisor for a reference?
- Yes
- No
Name of Supervisor
First Last
Email
(2) Company / Organization
Phone
Website
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Responsibilities
Dates of Employment
Reason for Leaving
May we contact your previous supervisor for a reference?
- Yes
- No
Name of Supervisor
First Last
Email

ESSAYS
Please answer as thoroughly as possible but keep each answer to 150 words or less.
(1) How did you come to Christ?*
Share events leading up to how you gave your life to Christ.
(2) How is the Lord currently working in your life?*
(3) What do you do on a regular basis to grow your personal relationship with Christ?*
(4) Why do you believe the Lord is leading you to serve with Push The Rock as an intern?*
(5) How are your abilities, experiences, and gifts a great fit for Push The Rock?*
(6) Describe your previous missions experience, including lessons you may have learned.*
(7) Describe any prior experience you have living and / or working in another country. How did that impact you and prepare you for this internship?*
(8) What are three of your greatest strengths and how do you anticipate using them in this internship?*

(9) What is one area of weakness for you and how will you overcome it during this internship?*
(10) What excites you about this opportunity?*
(11) What do you hope to accomplish and learn through this internship?*
(12) Describe your leadership qualities.*
(13) Describe your ability to work as a member of a team.*
(14) Describe any ministries in which you are currently involved.*
(15) Are there any specific factors that would keep you from committing fully to this internship? If so, please explain.*
(16) What passages of Scripture do you use in sharing the Gospel?*
Other Information
An application form sometimes makes it difficult for an individual to adequately summarize a complete background. Add any additional information below to summarize your full qualifications for the specific position for which you are applying for.
Certification
I am aware that any omissions, falsifications, misstatements, or misrepresentations above may disqualify me for employment consideration and, if I am hired, may be grounds for termination at a later date. I understand that any information I give may be investigated as allowed by law. I consent to the release of information about my ability, employment history, and or fitness for employment by employers, schools, and other individuals to Push The Rock staff for employment purposes. This consent shall continue to be effective during my employment if I am hired. I certify that to the best of my ability and belief all of the statements contained herein and on any attachments are true, correct, complete, and made in good faith. By submitting this application, I am acknowledging that I have read and am in agreement with Push The Rock's vision, mission and core values.
E-Signature*
First Last
Date
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Phone
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Internship Application - Missions

Internship Application - Missions

Step 1 of 7

Applicant Information

Emergency Contact

Background Information

Church Information

Health

Education

References

Sports Related Experience

Sports Ministry Experience

Work Experience (beginning with most recent job)

ESSAYS

Other Information

Certification

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