Servant Partners International Internship, Bangkok - Guide to ApplicationPage 1

Application Deadline: April 20, 2013 for international (non-local) applicants. For more information, please contact the internship coordinator at

Thank you for your interest in the Servant Partners International Internship! We are very excited about having you as a participant this year. We know that the decision to sacrifice your time and resources is significant, and we will be praying for God to lead you in this process. We trust that the Lord has many wonderful blessings in store for all of us this year!

The International Internship Application has several components. All of the documents need to be completed and sent to our office, along with a picture of yourself and non-refundable application fee of US$30. Spouses need to complete separate application forms.

We ask that you e-mail your completed application to n addition to mailing it! (If you do not have any computer access and need to have an application packet mailed to you, please e-mail us or call (626) 398-1010).

The following items must be submitted before your application can be processed.

Application Form: If possible, please complete this application on a computer (application can be downloaded in MS Word format from the Servant Partners website, Be sure to answer all of the questions. If a question does not apply to you, write N/A (not applicable) in the space provided.
One of the application questions (Relation to Overseas Work, #1) assumes that you have read the Servant Partners Introduction. This document describes Servant Partners’ values and strategy for overseas work. It is available to read on our website, or if you do not have access to the Internet, we can send you a hard copy.

If you have a current resume, please enclose a copy.

Confidential Reference Forms: Please download the Applicant Reference Forms, complete the top portion of four confidential reference forms and give them to the appropriate people (note that the type of reference is noted at the top of each form) to complete and return to Servant Partners. We strongly request that these be e-mailed to us rather than mailed. References needed (continued on next page):

The pastor/leader of your home church, Bible college or college fellowship.

Your current or most recent employer;

One close personal friend (not a relative);

Your physician/health care professional. Please fill in Part A of the form and then have your physician complete Part B. If you have had a physical examination within the last year, you do not need to have another one. Send the medical form to the doctor who performed the physical and ask him/her to complete it according to his/her records.

All of your references should have known you for two years. We request that all references be completed and sent directly to the Servant Partners office. Please contact the Internship Coordinator for the deadline for submission of references.

Agreements: Please read, sign, and return the Participation Agreement, Legal Waiver, and Photo Use Form.

Non-refundable Application Fee: Please send a check for US$30 made out to “Servant Partners” with “International Internship/your name” in the memo line. (Upon acceptance, this sum is deducted from your total financial responsibility.

Please complete your application on computer and e-mail to . Then, please print your completed application, sign and mail to:

Servant Partners

P.O. Box 3144

Pomona, CA 91769

Attn: International Internship

As soon as we receive all of the completed forms, including your references, at the Servant Partners office, we can begin to evaluate your acceptance to the International Internship. Please allow one to three weeks for a response to your application.

As part of the application process, you will be interviewed by a SP representative, which allows us to get to know each other better as we pray about God’s leading for your involvement in the International Internship. We will contact you after we receive your application to set up an appointment. (For groups with team leaders, individual team member interviews are not required.)

We look forward to getting to know you better through this process! If you have questions or require more information, please contact us at or call (626) 398-1010.

ConfidentialServant Partners International Internship - Application Page 1

GENERAL INFORMATION

Please Insert Recent
Photograph Here / First Name / Middle Name / Last Name
Date of Birth / Place of Birth / Age / Sex
Citizenship / Visa Status in US
(if applicable) / Ethnicity (this has no bearing on acceptance)
Passport Number / Place of Issue / Expiration Date
Current Street Address / City / State / Zip Code
Country / E-mail Address / Current Phone / Best Time to Call
Permanent Street Address / City / State / Zip Code
Country / Permanent Phone
Marital Status (Spouses need to apply separately)
Single / Divorced / Date:
Married / Date: / Widowed / Date:
Separated / Date: / Remarried / Date:
Is your spouse applying for the Internship? / Spouse’s Name
Dependent Children
Name / Date of Birth / Sex / Age / School Level
How did you hear about Servant Partners?
Next of Kin/Emergency Contact Person: / Relationship to you:
Current Street Address / City / State / Zip Code
Country / E-mail Address / Current Phone
What is your family's attitude toward this application?

Please provide us with the names and contact information for your four references* (three personal and one from your physician/health care professional) below:

Name / Address / Telephone & E-mail / Length of time known
Pastor/Leader:
Employer:
Friend:
Physician:

*Reference forms are available separately from this application. You must submit the reference forms unless you have been informed explicitly to bypass the procedure.

EDUCATION & WORK EXPERIENCE

Note: Your résumé may cover parts of this section.

1)We know that some of our applications will have undergraduate or graduate training. In the space below, list any undergraduate and graduate level training that you have received (both secular and theological) starting with the most recent training and working backward in time.
School & Location / Dates Attended / Area of Study / Degree Earned
1)Please list any other significant areas of study or training:
1)Please list any skills or technical abilities (e.g. engineering, mechanics, farming, construction, music, electronics, graphic art, typing, bookkeeping, TESOL, etc.) that you have:
1)Please list all significant overseas work conventions, seminars, workshops, etc. (e.g. Urbana) which you have attended (give date, location, duration, content):
1)Languages known with some degree of proficiency (low = 1, fluent = 4, high = 6):
Language / Speaking / Listening / Writing / Reading
1)What are some of your talents, hobbies, and personal interests?
1)Please list your places of employment over the past three years; start with your current or most recent job and work backward in time.
Dates of Employment / Name & Address of Employer / Title / FT/PT / Reason for leaving
1)What is your current job or means of income?

MINISTRY EXPERIENCE

1)Please list ministry roles that you have held using the chart below:
Dates: / Organization/Group (if any) / Brief Job Description / FT/PT / Paid or Volunteer
1)Please list and date all cross-cultural experience not mentioned above (employment, on campus, vacations, travel, short-term overseas, etc.).
Dates / Location / Description of Experience
1)What do you believe to be your spiritual gifts (please list)? How have you had opportunity to use them?
1)Do you know your Myers-Briggs personality type? If so, please indicate:

HOME CHURCH INFORMATION

Home Church Name: / Denomination:
Street Address: / City: / State: / Zip Code:
Phone: / Fax: / E-mail:
Pastor’s Name: / Outreach / Overseas / Global work Chairperson
Are you a member? If yes, for how long?
How would you characterize yourself (check all that apply)?
Mainline / Evangelical / Charismatic
Pentecostal / Catholic / Other:
Would you have reluctance in serving or ministering with any of the above? If so, which and why?
Do your pastor and outreach committee know that you are applying for the Internship?Are they supportive of your plans?

DOCTRINE

Please answer the following questions briefly (one or two sentences). If you do not have an answer to a particular question, feel free to state this. We are not looking for the “right” answers to these doctrinal questions; we would like to get to know you and be aware of your ideas and positions on these issues.
1)How do you know when someone is a Christian?
1)What is your view of the Bible and its practical use in a Christian’s daily life?
1)What do you regard to be the relationship between faith and social action (Christian involvement in society in order to improve unjust conditions)?

CHRISTIAN EXPERIENCE & CHARACTER DEVELOPMENT

1)Describe your personal conversion experience.
1)How do you maintain a real, living relationship with God?
1)What do you appreciate the most about Jesus right now in your relationship with Him?
1)How has God spoken/challenged/led you recently?
1)What do your friends like best about you?
1)What are your greatest strengths and why?
1)What are your greatest weaknesses and why?

RELATIONSHIP TO OVERSEAS MINISTRY

1)Have you carefully read over the Servant Partners Introduction (available on the SP website)? Please detail any areas in this Introduction that you: (a) do not fully understand; and/or (b) cannot wholeheartedly endorse at this point.
1)Why do you want to participate in this internship?
1)Complete this sentence: In this internship, you will feel you accomplished what you wanted to when you…
1)Do you have any reservations about working under the direction of leaders of another gender, race, nationality or culture? If so, please explain.
1)Will you be seeking internship/independent study credit for this program? If so, what are the requirements for your internship/independent study?

MISCELLANEOUS

Is there anything else you would like us to know about you as we pray for you and consider this application? Use the space below to add any additional thoughts, questions, or prayer requests you have for us at this time.
Do you have any food allergies we should be aware of (or other significant health concerns)?

Please print your completed application, sign and mail to:

Servant Partners

P.O. Box 3144

Pomona, CA 91769

Attn: International Internship

In addition, please email all forms to:

Again, please contact the Internship Coordinator for information on the deadline for your application. If you have questions or require more information, please contact us at or call (626) 398-1010.

ConfidentialServant Partners International Internship, Bangkok - ApplicationPage 1

I have applied to participate in the International Internship, and understand that if I am accepted, my participation in the program depends on the completion of all of the application and preparation requirements given to me by Servant Partners. I am aware that I need to discuss my participation in the program with my church leaders and family. I understand that Servant Partners needs to receive the entire cost of my program one month prior to my departure.

I will remember that my life, attitudes and actions reflect on others, Servant Partners and the Lord. If unforeseen problems or conflicts should arise, I will seek to deal with them in a culturally appropriate and biblical way. I understand that while I am overseas, I am under the leadership of Servant Partners personnel and will accept and submit to their authority over me. I understand that Servant Partners maintains the right to remove me from the program at any point my participation is hindering the on-going work of Servant Partners International.

I realize that my role on the field is not that of a tourist, and I must act with cultural sensitivity while I am there. I will seek by my lifestyle and attitude to glorify God. This includes modesty and neatness in my dress, polite speech and behavior, as well as propriety in my relationships with those of the opposite sex. I will aim to be content in all circumstances, even when living without modern conveniences. I will seek to be a learner, a team-player, and a respecter of the customs and national culture of the country in which I am serving. I will obey the local laws.

I understand the importance of one to one trusting relationships as a basis for effective sharing of the gospel. I will seek to be a witness with both my words and actions, and will avoid activities that could offend or harm others. I will submit to the authority of the long-term workers in regards to ministry strategy and practices in the community.

I understand that I will need to inform my financial supporters that donations toward my program are to be sent to Servant Partners, P.O. Box 3144, Pomona, CA 91769 with “International Internship/my name” in the memo portion of the check. I will also inform my supporters that any funds sent to Servant Partners, for which tax-deductible receipts have been issued, cannot be returned to them. I understand that all contributions are considered by the Internal Revenue Service to be donations to the International Internship and if contributions exceed my personal program cost, excess funds will not be returned to donors or to me. If it is determined during the preparation time by myself or Servant Partners that I do not participate in the International Internship, I understand that, in order to satisfy IRS requirements, donations received on my behalf cannot be refunded to either my donors or to me. I am aware if I am sent out by another agency within 12 months, Servant Partners would be able to forward funds to that organization on my behalf (excluding the amount of application fees and non-refundable costs).

Signature:______Date: ______

Servant Partners International Internship – Legal Waiver/Agreement Page 1

I, ______(full name of applicant) acknowledge that I have applied to the International Internship, and that if accepted by Servant Partners, Inc. (hereinafter “SP”) I will plan to travel to ______

beginning on or about __September, 2013__ and returning on or about __July, 2014__

In consideration of my acceptance, I hereby represent and agree as follows:

1.I shall accept, abide by and follow all reasonable SP instructions and directions whether written or oral relating to my participation in this program.

2.I shall pay and be responsible for all expenses that I incur (other than those which SP has specifically agreed to pay, in writing); and shall not seek reimbursement from SP or from any of its members, representatives, employees, contractors or agents (“related persons”) for expenses which SP has not so agreed to pay.

3.I have no presently existing health or medical conditions or limitations, except those that I have disclosed in writing to SP as part of the application process for this travel. I understand that with respect to any such condition or limitation the decision to participate in this program is my own with the advice of my physician. SP and its related persons shall have no responsibility for any such condition. I accept full financial and other responsibility for any illness, injury, or death caused in whole or in part by any presently existing health or medical condition or limitation.

4.I accept full responsibility for and shall pay or reimburse SP for payment of any and all costs of health and medical care or treatment and for the cost of repatriation related to such, if required, incurred by me which are paid by SP, which are related to participating in this program. I shall not seek payment or reimbursement from SP for such costs or expenses, or any related costs or expenses which I pay myself. I understand that I will be covered under traveler’s health insurance obtained with my funds on my behalf by SP, while I am in Asia, but before my departure, and upon my return to the United States, I am responsible for my own health insurance coverage and expenses.

I understand that I am free to notify SP and purchase my own health care and “air ambulance” coverage, if it provides benefits substantially equal to or greater than those of the policy SP obtains on my behalf. [The policy SP provides may provide only limited air ambulance coverage for repatriation.] A copy of the travelers’ health insurance policy will be provided to me, at my request, following my acceptance and receipt of the required internship fees as determined by the staff. I accept responsibility for understanding the extent of the coverage and any deductibles and co-pays. I agree that I (and not SP) must pay deductibles, co-pays, and expenses not covered by the policy.

5.I authorize SP and its related persons to obtain and authorize on my behalf any and all health and medical care and treatment for me in the event of my illness or injury and to obtain from physicians and hospitals and their staff all information relating to my medical condition. Neither SP nor any of its related persons shall have any liability for authorizing or failing to authorize any such care or treatment. Any physician or other health care provider or facility may render all care and treatment and perform all procedures, including anesthesia, deemed advisable in attempting to treat or relieve any health or medical condition. I acknowledge that medical care and treatment outside of the United States may be limited and may be below the standard that is usual and customary within the United States.

6.Neither I, my estate, members of my family nor anyone acting on behalf of myself or estate or family shall have or assert any claim or demand against SP or any of its related persons in the event of my death, injury, illness, or property damage or loss resulting from my participation in this program, unless caused by their gross negligence or willful misconduct. SP and its related persons shall not be responsible for the negligence or misconduct of any person or entity providing health care to me.

7.I shall indemnify and hold SP and each of its related persons harmless in the event of any claim or liability by reason of any actual or alleged act or omission alleged to have been caused or performed by me, or by any reason of any breach or alleged breach on my part of this agreement. I agree to pay any and all attorneys fees, costs of suit, and incidental expenses of SP and its related persons therein incurred by reason of such claim, liability, or breach.

8.I acknowledge and agree that my participation in this program may be terminated at any time by SP, with or without cause.