Ministry Information
Please describe your current relationship with your local church. How have you served in your local congregation?
Leadership Experience (check all that apply):
I am currently leading a small group(s).
I am currently leading a Bible Study.
I am currently leading a prayer meeting(s).
I am currently in a leadership position in my church.
I am not currently in any leadership roles.
Other Leadership Experience
Please describe any ministry training that you have received and any ministry leadership involvement.
(Describe your interest and involvement in cross-cultural missions)
I definitely want to go overseas as a long-term missionary (over 2 years).
I definitely want to go overseas as a short-term missionary (2 years or less).
I want to be involved in cross-cultural ministry in my own country.
I am exploring cross-cultural missions as a possibility, but not yet sure if this is what God has for me.
I am not interested in cross-cultural missions at all.
Other (specify below)
Describe your interest and involvement in cross-cultural missions
Other interest or involvement in missions
Please assess yourself in the following areas.
(Reliability)
Uncertain
Weak
Fair
Good
Outstanding
Reliability
(Devotion to Jesus)
Uncertain
Weak
Fair
Good
Outstanding
Devotion to Jesus
(Working without supervision)
Uncertain
Weak
Fair
Good
Outstanding
Working without supervision
(Ability to work with others)
Uncertain
Weak
Fair
Good
Outstanding
Ability to work with others
(Leadership)
Uncertain
Weak
Fair
Good
Outstanding
Leadership
(Family Life)
Uncertain
Weak
Fair
Good
Outstanding
Family Life
(Physical Health)
Uncertain
Weak
Fair
Good
Outstanding
Physical Health
(Emotional Stability)
Uncertain
Weak
Fair
Good
Outstanding
Emotional Stability
(Spiritual maturity)
Uncertain
Weak
Fair
Good
Outstanding
Spiritual maturity
(Willingness to serve)
Uncertain
Weak
Fair
Good
Outstanding
Willingness to serve
(Communication skills)
Uncertain
Weak
Fair
Good
Outstanding
Communication skills
(Personal Hygiene/Cleanliness)
Uncertain
Weak
Fair
Good
Outstanding
Personal Hygiene/Cleanliness
(Self-discipline)
Uncertain
Weak
Fair
Good
Outstanding
Self-discipline
(Openness to correction)
Uncertain
Weak
Fair
Good
Outstanding
Openness to correction
(Teachability)
Uncertain
Weak
Fair
Good
Outstanding
Teachability
(Integrity and honesty)
Uncertain
Weak
Fair
Good
Outstanding
Integrity and honesty
What would you consider to be your talents, gifts, and strengths?
What would you consider to be your struggles and weaknesses?
Are you a worship leader, singer, or do you play a musical instrument? If so, describe your experience and skills.
Financial Information
(Do you currently have any financial debt?)
Yes
No
Do you currently have any financial debt?
Please explain your plans for managing your debt (if any) if accepted into the school.
How do you plan on paying for Summer Experience?
Are you prepared to trust God fully for your financial support? Are you comfortable support raising? Please discuss your vision and convictions related to raising support as an intercessory missionary.
(Do you plan on bringing a vehicle?)
Yes
No
Do you plan on bringing a vehicle?
Health Information
(ADD or ADHD)
None
Mild
Moderate
Severe
ADD or ADHD
(Mild depression)
None
Mild
Moderate
Severe
Mild depression
(Chronic depression)
None
Mild
Moderate
Severe
Chronic depression
(Chronic pain)
None
Mild
Moderate
Severe
Chronic pain
(Diabetes )
None
Mild
Moderate
Severe
Diabetes
(Long-term medication)
None
Mild
Moderate
Severe
Long-term medication
(Seizures)
None
Mild
Moderate
Severe
Seizures
(HIV/AIDS)
None
Mild
Moderate
Severe
HIV/AIDS
(Sexual Transmitted Disease(s))
None
Mild
Moderate
Severe
Sexual Transmitted Disease(s)
(Allergies)
None
Mild
Moderate
Severe
Allergies
(Alcohol abuse)
None
Mild
Moderate
Severe
Alcohol abuse
(Drug abuse (including cigarettes or prescription drugs))
None
Mild
Moderate
Severe
Drug abuse (including cigarettes or prescription drugs)
(Chronic fatigue syndrome)
None
Mild
Moderate
Severe
Chronic fatigue syndrome
(Eating disorders (bulimia, anorexia, diet-obsessive, etc.))
None
Mild
Moderate
Severe
Eating disorders (bulimia, anorexia, diet-obsessive, etc.)
(Communicable diseases)
None
Mild
Moderate
Severe
Communicable diseases
Please explain anything you marked above or any other health issues.
(Do you have any physical disabilities or health conditions that require special care?)
Yes
No
Do you have any physical disabilities or health conditions that require special care?
(Do you have any substance abuse problems or addictions?)
Yes
No
Do you have any substance abuse problems or addictions?
(Do you currently have, or have you ever had, any life-controlling mental, emotional, or relational issues?)
Yes
No
Do you currently have, or have you ever had, any life-controlling mental, emotional, or relational issues?
(Do you struggle with eating disorders or low self-image ?)
Yes
No
Do you struggle with eating disorders or low self-image ?
(Do you struggle with pornography or other forms of sexual immorality?)
Yes
No
Do you struggle with pornography or other forms of sexual immorality?
(Have you ever voluntarily or involuntarily received help for psychological, sexual, emotional, or relational problems?)
Yes
No
Have you ever voluntarily or involuntarily received help for psychological, sexual, emotional, or relational problems?
(Have you ever taken or been prescribed medication related to psychological problems?)
Yes
No
Have you ever taken or been prescribed medication related to psychological problems?
(Are you currently under a prescription for medication related to psychological problems?)
Yes
No
Are you currently under a prescription for medication related to psychological problems?
(Have you ever been accused and/or reported for physically or sexually abusing someone?)
Yes
No
Have you ever been accused and/or reported for physically or sexually abusing someone?
(Do you have a police record?)
Yes
No
Do you have a police record?
(Have you ever attempted or considered suicide?)
Yes
No
Have you ever attempted or considered suicide?
(Do you currently wrestle with suicidal thoughts?)
Yes
No
Do you currently wrestle with suicidal thoughts?
If you answered yes to any of the questions above, please explain.