2017 Returning Intern Application - Summer Impact
Name *
Your answer
Position of Interest *
(check all that apply)
Required
Present Address *
Your answer
Contact Phone Number *
Your answer
Email Address *
Your answer
Date of Birth *
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Sex *
Place of Birth *
Your answer
Citizenship *
Your answer
Marital Status *
Church Membership *
(Church name and denomination)
Your answer
Name of Pastor *
Your answer
Church Address *
Your answer
Church Telephone Number *
Your answer
What UM Annual Conference is your church part of? *
(if applicable)
Your answer
What year(s) were you a Summer Impact Intern? *
Your answer
How have you grown since you were a Summer Impact Intern? *
Your answer
This year, what will be different? What will you do/hope to do differently? *
Your answer
How will you step into a new team? *
Your answer
If you could wave a magic wand, what would be something Summer Impact could adapt or change during the summer of 2017? *
Your answer
Please list your significant employment positions, starting from the most recent. *
(List dates of employment, employer, location, and type of work)
Your answer
You are responsible for sending reference forms to three people. You may select any three people (except relatives), but they MUST BE SOMEONE WHO KNOWS YOU WELL. (Examples of people who would make good references would be: pastor, employer, supervisor, teacher, etc). Please list the three individuals you will send references to below. *
(Include first an last name, email, relationship to you, and phone number)
Your answer
Additional comments you wish to share
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