CTCI Summer Internship Application

Emergency Contact Information
First Contact*

First NameLast Name
Phone Number*

Area CodePhone Number
Email*
example@example.com
Second Contact*

First NameLast Name
Phone Number*

Area CodePhone Number
Email*
example@example.com
Primary Health Insurance*
Policy Number
Insured's Name

First NameLast Name
Covenant

While serving as an intern/staff assistant in the CTCI Summer INNternship, I agree to adhere to the highest moral standards in conduct and dress and to submit to the oversight of the CTCI Staff. I agree there should be NO use of alcohol, tobacco, or illegal drugs. As the variety of classes, activities, and chores present themselves, I am willing to do any tasks assigned.

I understand that in addition to assigned duties, an integral part of the Internship/Assistantship will be specialized Heroes of Today training activities in which I will participate.
Electronic Signature*

First NameMiddle NameLast Name
Date*

MonthDayYear
Signature of Participant*

First NameLast Name

Please write a brief testimony concerning your Christian faith.*
Please write a summary of any ministries or extra curricular activities you have participated in.*
What do you believe are your strengths in regards to the Summer Internship?*
What areas personally do you feel you need to grow in most at this time in your life?*
Describe your current relationship with the Lord and why you feel He is leading you to serve at CTCI this summer.*

References
Please list three references (NOT including family members or peers) whom you feel know you well.
Reference #1*

First NameLast Name
Position/Relationship*
Phone Number*

Area CodePhone Number
E-mail or Facebook*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Reference #2*

First NameLast Name
Position/Relationship*
Phone Number*

Area CodePhone Number
E-mail or Facebook*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Reference #3*

First NameLast Name
Position/Relationship*
Phone Number*

Area CodePhone Number
E-mail or Facebook*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Should be Empty:

CTCI Summer Internship