Application for Lifechangers Intern Position

Complete and submit this form to be considered for a Lifechangers internship.

First Name Last Name

Email Address

Best phone number to reach you
Extension

Address Line 1

Address Line 2

City

State

ZIP Code

Church where you are a member:

Do you have health insurance?
YesNo

Have you ever been convicted of a felony?
YesNo

Have you ever been convicted of sexual harassment or abuse?
YesNo

Have you ever been convicted of child endangerment, abuse, or neglect?
YesNo

Name of your pastor

What ministries have you been involved in through your church or other Christian organizations?

What language do you speak, other than English?
NoneSpanishPortugueseChineseKoreanOther

Reference #1: Give name, your relationship to this person, email address, and best phone number:

Reference #2: Give name, your relationship to this person, email address, and best phone number:

Tell us about your walk with Jesus:

Why do you want to serve as a Lifechangers intern?