Host Family Application
This application is for those who wish to host an Ignite Intern. People from all over the world have shown interest in coming here to immerse themselves in the culture of the Healing Rooms. What they receive here will make a lasting impact in their lives. Thank you for your interest in partnering with God to empower people for kingdom ministry!
Email address *
Which Internship session do you wish to host a student? *
Required
Name *
First & Last Name
Your answer
Address *
Street, City & Zip
Your answer
Email *
Your answer
Phone number *
Your answer
Name & age of children living in the household *
Your answer
Name & age of other household residents *
Your answer
Have you accepted Jesus as your Lord & Savior? If yes, when? *
Miles and/or drive time
Your answer
How far do you live from the Healing Rooms? *
Miles and/or drive time
Your answer
How long have you been coming to the Healing Rooms? *
Your answer
What church do you attend? *
Your answer
How long have you attended your current church? *
Is your families diet unusual or special? *
Your answer
Could you accommodate an intern with special dietary needs? *
Your answer
Describe the work schedule/daily routines of you and your spouse *
Your answer
What interests or hobbies does your family enjoy? *
Your answer
Are you in a position to provide room and board for two months? *
Would you prefer a male or female student? *
Would you be interested in housing more than one student?
Would the student(s) share a bathroom or bedroom? *
If yes, with whom would they share a bathroom or bedroom with?
Your answer
What pets do you have? *
Your answer
Why are you applying to be a Host-Family? *
Your answer
Any other important information we should know about?
Your answer
Please email a picture of the bedroom & bathroom the student(s) would be using.
Please send email to jacob@healingroomssmv.com - thanks!
Your answer
Please provide a pastoral reference.
Name, Phone & Email
Your answer
Please list any ministries in which you are currently involved.
Name, Phone & Email
Your answer
Please list any ministries in which you have served in the past.
Name, Phone & Email
Your answer
Thank you. We look forward to impacting lives with you!
If you have any questions, feel free to email Jacob Justice at jacob@healingroomssmv.com
or call Jim Douglas at (805) 310-9912. For the safety of all persons involved at the Healing Rooms Apostolic Center and the Ignite Internship, a national background check will be performed on all host family and intern applicants. Our leadership & pastoral staff reviews all applicants prior to acceptance.
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