Revolution Student Ministries Dear Interested Applicant, Thank you! We are excited that you are interested in becoming an intern with Revolution Student Ministries. Enclosed in this packet is the information necessary to begin processing your application to join our team. Please return the completed application to the Student Ministries department as soon as possible. We have enclosed an envelope for your convenience. Please be sure to sign the application and the authorization for release of background information. You will also need to make copies of the parental and pastoral recommendation forms to give to whomever you’ve selected. After they complete the forms they’ll need to mail them separately to the address provided on the form. Once your application and recommendations have been received in the office, someone from the Revolution Student Ministries staff will contact you regarding the internship. We are looking forward to getting to know you and working alongside you to reach this generation. Thank you for considering involvement in this vital and rewarding area of ministry. If you have any questions or concerns, feel free to contact our office at 724-453-6200. Equipping this Generation,
Pastor Nathan Hurst
Victory Family Church Qualifications Christians who are in places of responsibility in the church are required to be examples in faith, conduct, and business affairs. To maintain a high standard for workers is one of the best ways to present Christ to the people of our community. Therefore, the following guidelines will be required of any person who works in Student Ministries of Victory Family Church. You must ‌ 1. 2. 3. 4. 5. 6. 7. 8. 9.
Be in agreement with the tenets of faith of Victory (On the next page). Complete a Student Ministries Worker Application. Be loyal to the pastors and leaders of Victory. Be faithful to your assigned position. Live a separated Christian Life. Attend Student Ministries workers' meetings and workshops. Be faithful in attendance to regular church services. Give at least three (3) days notice if you know you will be absent. Be neat in appearance.
VICTORY FAMILY CHURCH BACKGROUND INVESTIGATION CONSENT I, _______________________________________________, hereby authorize Victory Family Church, and/or its agents to make an independent investigation of my background, references, character, past employment, education, criminal or police records, including those maintained by both public and private organizations and all public records for the purpose of confirming the information contained on my Application and/or obtaining other information which may be material to my qualifications for employment or volunteer service now and, if applicable, during the tenure of my employment or volunteer service with Victory Family Church. I release Victory Family Church and/or its agents and any person or entity, which provides information pursuant to this authorization, from any and all liabilities, claims or law suits in regards to the information obtained from any and all of the above referenced sources used.
The following is my true and complete legal name and all information contained herein is true and correct to the best of my knowledge: _____________________________________________ ______________________________ Applicant/Employee Signature Date __________-_______-____________ _______________________________ Social Security Number * Date of Birth * ______________________________
Driver’s License Number
Circle one: Male / Female
*NOTE: The above information is required for identification purposes only, and is in no manner used as qualifications for employment. Victory Family Church is an Equal Opportunity Employer, and does not discriminate on the basis of Sex, Race, Religion, Age (40 and over), Handicap or National Origin.
Printed Name _________________________________________________________ Street Address_________________________________________________________ City, State, Zip ________________________________________________________ Would you be opposed to an official background check through a PA State Criminal Record Check or an Investigative Agency if we believe it necessary? yes no
Victory Family Church Statement of Faith We Believe . . . ..
. that the Bible is the inspired and only infallible authoritative Word of God.
-(II Tim. 3:16)
. . . in one God, Maker of all things who eternally exists in Trinity as three persons: Father, Son, and Holy Ghost. -(I John 5:4-7; John 1:1-14) . . . in the Deity of our Lord Jesus Christ, His virgin birth, His sinless life, His miracles, His vicarious and atoning death through His shed blood, His bodily resurrection, His ascension to the right hand of the Father, and His personal return in power and glory. -(I Cor. 15:3; I Peter 2:23-24; John 3:16) . . . that for salvation of lost and sinful man, regeneration by the Holy Spirit is absolutely essential. -(Rom. 3:21-30; Gal. 4:4-7) . . . that the full consummation of the baptism of believers in the Holy Ghost is evidenced by the initial physical sign of speaking with other tongues as the Spirit gives utterance, and by the subsequent manifestation of spiritual power in public service. -(Acts 1:8; 2:42-43; 10:44-46; 19:2-6; Matt. 3:11) . . . in the resurrection of both the saved and lost; those who are saved unto the resurrection of life and those who are lost unto damnation. -(John 5:24-29) . . . that deliverance from sickness is provided for in the atonement, and is the privilege of all believers. -(Isaiah 53:4; Matt. 8:16-17; Mark 16:18) . . . in the imminent return of our Lord and Savior, Jesus Christ. -(I Thess. 4:16-18; Rev. 22:20)
Intern Application General Information:
Rank the Applicant in the following areas: Excellent
Above Average
Average
Below Average
Emotional Stability Leadership Ability
Full Name: _________________________________________________ Date: _____________
Social Ability
Name you prefer: ____________________________________ Gender: ___ Male ___ Female
Spiritual Maturity
Email: ___________________________________________Date of Birth: _________________ Address: _____________________________________________________________________ Primary Phone: _________________________ Secondary Phone: _______________________ Occupation: ________________________________ Employer: __________________________ Work Status: part time: _____ full time: _____ student: _______ Marital Status: single: ___ married: ___ divorced: ___ other: ________________(list) Spouse’s Name: ___________________________________ Anniversary Date: _____________ Children: _________________________________________________ Ages: _______________ Education:
Based on your relationship with the applicant would you ____strongly recommend, _______recommend, _______not recommend them for admission in the internship? Would you mind if we called you to talk about the applicant? ____Yes _____No Please write a brief recommendation letter telling us why we should or should not allow the applicant to become an intern in our ministry. Signature:________________________________________________ Date:___________________________
High School: _________________________________Year Graduated: ______ GPA:________
Once you have completed this recommendation, please mail this form to the address below:
College/Trade School: __________________________Year Graduated: ______GPA:_______
Attn: Revolution Staff—Internship 21150 Route 19 Cranberry Twp., PA 16066
Degree: __________________________________________________ Other Education: ___________________________________________Year Graduated: ______ References: Due to the fact that interns in this area of ministry are in close contact with minors, we are in need of two non-family non-pastoral personal references. Please list two people that you have known for more than two years. Reference #1: Name: ________________________________________ Primary Phone: _________________________________ Email Address: __________________________________ Relationship: ___________________________________ How long have you known this person: ______________ Reference #2: Name: ________________________________________ Primary Phone: _________________________________ Email Address: __________________________________ Relationship: ___________________________________ How long have you known this person: ______________
Pastoral Recommendation Applicant’s Name:________________________________________________________
Personal Information: Write a brief testimony about how you became a Christian (include date).
Thank you in advance for your help. Each student must submit a pastor’s recommendation. We are interested in your assessment of this student’s spiritual development. Serious consideration will be given to your comments; therefore, we ask that you complete this form carefully. Please comment on the student’s level of commitment to spiritual growth, participation in a church or organization, and potential to contribute to a Christian community. The Revolution internship seeks to admit students who will thrive in a distinctly Christian learning community. Members of this internship are committed to Christian values and actively participate in the integration of faith and learning. Students in the Revolution internship commit to specific standards which are found in our brochure. These policies comply with state and federal laws regarding alcohol and drugs. Further, students will refrain from the possession and use or being under the influence of alcohol, tobacco, and non-prescriptive drugs during their time as a student in this program. Students in the Revolution internship will also refrain from immoral sexual behavior and from the possession and use of obscene or pornographic images or literature and will strive for an attitude of purity. Students will be coached and counseled if they struggle with these matters. These standards are established in order to provide a healthy environment for growth and learning. If you have any questions, please call Bubba at 724.453.6200 x.305.
Name________________________________________ Church_______________________________________ Phone________________________________________ E-mail__________________________ Church Address: _______________________________________________________________________________ City/State/Zip:___________________________________________________________________
Do you consider yourself to be a committed believer? Do you feel like you are active in your walk with God?
How long have you known the applicant ___________________________________________ How well do you know the applicant? ________very well ______well ______casually Do you feel that the applicant has the necessary qualities to succeed in the internship? ____Yes ___No If not, why? _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ Do you know the applicant has a personal relationship with Jesus Christ? ______Yes _____No To your knowledge, is the applicant’s present conduct consistent with the lifestyle described above? ____Yes ____No
How would you describe your personal journey now?
Briefly identify the applicant as either active, average, or indifferent as far as their participation in the activities of your church/youth ministry. _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________
What people or experiences have been most significant in your growth as a Christian?
What kind of accountability structure do you have in your life? (small group, mentor, etc.)
Are there any issues or concerns that would have a negative impact on your commitment and involvement in student ministries?
Ministry Information: Please describe any past ministry or church experience that you have been involved in. What did you do and who was the leader?
Parental Recommendation This program is church-related and supportive of parental authority in student’s lives; therefore, we request your cooperation in completing this form. All information will be held in strict confidence.
List the date and activities of other ministry experiences here at Victory and the reasons for leaving that ministry.
Name of Applicant:__________________________________________ Family Information Your Name______________________________ What relationship does the applicant have to you? _____ Son ______ Daughter ______ Other
What spiritual gifts and strengths do you feel that you have and how would you like to use them in student ministries?
Has the applicant had any serious problems submitting to parental or other authority? _____ Yes _____No Please Comment: _________________________________________________________________________________ _________________________________________________________________________________
What is one area that you would like to grow as a leader?
Do you have any fears or areas of weakness that might affect where you serve in ministry? (For example: speaking in front of people, large crowds, etc.)
Has the applicant read through and discussed with you the guidelines and standards of the Revolution internship? _____ Yes _____No Understanding that it is our desire that there be no conflict with parental and church authority, would you be supportive of these guidelines and standards? ______ Yes ______ No Parental Church Information Church Presently Attending: __________________________________________________________ Pastor’s Name________________________________________ Phone________________________ Address:__________________________________________________________________________ City/State/Zip _____________________________________________________________________ Website__________________________________________________________________________ Parental Approval
Why do you want to serve in student ministries?
Do you fully approve of the applicant participating in the Revolution Internship? _____ Yes ____ No Comments: _________________________________________________________________________________ _________________________________________________________________________________ Parental Signature_________________________________ Date:______________________________ Once you’ve completed this recommendation, please mail this form to the address below: Victory Family Church Attention: Revolution Internship 21150 Route 19
Church Information: Do you call Victory your church home? _____________
Health Information Please describe any physical limitations, disabilities, or health issues that you may have: _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________
Are you a member (completed the class & application) _________________ If not, what church do you call home? ___________________________ How long have you been attending Victory? _____________ Have you completed:
Membership Classes ______ Equip ______
Finances What is your anticipated source of income while in the internship? _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ Will you be able to fulfill your payments required for Victory Bible Institute? _____ Yes ______ No Do you currently own a vehicle? _____ Yes _____ No If not, how will you get to the church? _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ Do you currently have automobile insurance for your vehicle? _____ Yes _____ No Policy Number_____________________ Agent’s Name______________________ What current debts, loans, or payments do you have (List the amount owed)? _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________
List the churches you have attended during the past seven years: (list most recent first) Church: __________________________________________ Dates Attended _________________ Address: ________________________________________________________________________ Phone: ______________________________________Pastor: _____________________________ Ministries involved in: ______________________________________________________________ Ministry Contact Person: ____________________________Phone number: __________________ Reason for leaving_________________________________________________________________ Church: __________________________________________ Dates Attended _________________ Address: ________________________________________________________________________ Phone: ______________________________________Pastor: _____________________________ Ministries involved in: ______________________________________________________________ Ministry Contact Person: ____________________________Phone number: __________________ Reason for leaving_________________________________________________________________ Attach an additional sheet if necessary.
Will these be paid off by the time you enter the Revolution internship? _____Yes ______ No
What’s Your Shape? All leaders have unique qualities and interests that they can use to serve students. Below are some questions designed to help us plug you into an area of ministry that fits who you are.
If not, how do you plan to make these payments? _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________
What do you feel are your spiritual gifts? 1. ___________________________
APPLICANT’S STATEMENT The information contained in this application is correct to the best of my knowledge. I authorize any references or churches listed in this application to give you any information they may have regarding my character and fitness for youth work, and I release all such references from liability for any damage that may result from furnishing such evaluations to you. Should my application be accepted, I agree to be bound by the constitution and by-laws and policies of Victory Family Church and to refrain from unscriptural conduct in the performance of my services on behalf of the church. Applicant’s signature______________________________________________Date_____________
2. ___________________________ 3. ___________________________ In what areas have you been able to use these gifts in the past?
What are three things that you love to do? 1. ___________________________ 2. ___________________________ 3. ___________________________
My strongest abilities are: (A few suggestions include drama, writing, speaking, photography, etc.)
Have you ever been arrested for a crime? Yes _______ No _______
1. ___________________________
Have you ever been convicted of a crime? Yes _______ No _______
2. ___________________________
Have you ever had sexual relations with any minor after you became an adult? Yes _______ No _______
3. ___________________________
Have you ever been accused of any form of child abuse? Yes _______ No _______
This is How I See Myself: (Circle the one that applies to you for each comment)
Around Others I am more……………… My decisions are based more on………. In my relationships, I tend to be more…. My use of time is more…………………….
Reserved Facts/Thinking Dependent on Others Determined
Outgoing Feelings Independent Spontaneous
Have you ever been convicted of any form of child abuse? Yes _______ No _______ Have you ever been a victim of any form of child abuse? Yes _______ No _______ If yes, would you like to speak to a pastor? Yes _______ No _______ Do you view X-rated movies, visit adult bookstores or clubs, read X-rated magazines or look at internet pornography? Yes _______ No _______
What was one significant experience that you had in your teenage years?
Are you willing to undergo a background check? Yes _______ No _______ When I have free time, I spend it……….
If single, are you pursuing a relationship that is honoring to God? Yes _______ No _______ Are you currently maintaining a personal blog, website, myspace, or facebook account? Yes _______ No _______
The purpose that I am most passionate about is………….(circle one) Evangelism
Fellowship
Discipleship
Ministry
Worship
because _______________________________________________________________________ ______________________________________________________________________________
If yes, please provide addresses/URL: _______________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________
Lifestyle and Legal Concerns: In caring for students, we believe that it is our responsibility to seek adult leaders that can provide healthy, safe, and nurturing relationships. Please answer the following questions accordingly. Are you currently or have you ever used illegal drugs? Yes _______ No _______ Have you ever gone through treatment for alcohol or substance abuse? Yes _______ No _______ Have you been arrested and/or convicted of a crime? Yes _______ No _______
______________________________________________________________________________ Do you have anything posted on your personal site that would create a negative perception of Revolution Student Ministries or Victory Family Church? Yes _______ No _______