Christian Ministry Internship Application

For Christian Ministry, Youth Ministry, and Worship Arts Programs

Please complete this entire form. Ensure that all the information you provide is accurate and up-to-date. Once you have completed the form, your Program Coordinator will contact your placement site Mentor. You will then be notified if your placement site meets the requirements for internship. If it does, you can then proceed with completing the Learning Contract with your Mentor.

Internship Details
Course Code
Course Title
Start Date Start Date / MM / DD YYYY
Completion Date Completion Date / MM / DD YYYY
Is this a three-credit hour or six-credit hour internship?

Is this a three-credit hour or six-credit hour internship? Three-credit Six-credit
To which semester would you like to have this course charged?

To which semester would you like to have this course charged? Summer semester Fall semester Winter semester
Student Intern Information
Name Name First Last
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Email
Phone Phone - ### - ### ####
Credit hours completed before starting internship
Does the internship align with your program and/or concentration?

Does the internship align with your program and/or concentration? Yes No
Year of intended graduation
Program Coordinator Information
Name Name First Last
Internship Mentor Information
Name Name First Last
Title
Organization
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Email
Phone Phone - ### - ### ####
Does the Mentor have five years of ministry experience?

Does the Mentor have five years of ministry experience? Yes No
Has the Mentor served in their current role for at least one year?

Has the Mentor served in their current role for at least one year? Yes No
Has the Mentor received a copy of the Internship Manual?

Has the Mentor received a copy of the Internship Manual? Yes No

Christian Ministry Internship Application

Christian Ministry Internship Application

Internship Details

Student Intern Information

Program Coordinator Information

Internship Mentor Information