Summer Staff Application
MOBILIZING STUDENTS
805 S. Glynn Street
Suite 127, #167
Fayetteville, GA 30214
678.763.2134
www.mobilizingstudents.com
Personal Information
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Upload a Photo of Yourself
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First Name
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Last Name
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Birth Date
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Grade
12th
College Freshman
College Sophore
College Junior
College Senior
College Graduate
Graduate School
Post-Graduate School
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Age
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Sex
M
F
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T-shirt
S
M
L
XL
2XL
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Address 1
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City
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State
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Zip
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Your Cell Phone/Contact Phone
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Email Address
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What church do you attend?
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Provide the First & Last name of the church staff person who would recommend you?
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Please list the email address of that staff person.
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List the college/university you attend or attended?
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What Year?
Freshman
Sophmore
Junior
Senior
Graduate School
Post-Graduate School
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List any Myspace, Facebook, or other personal web pages you have.
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Describe when & how you came to know Christ.
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What do you sense God calling you to do with your life?
Primary Adult/Guardian Contact
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Relationship to Applicant:
Self
Mother
Father
Guardian
Other
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First Name
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Last Name
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Address 1
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City
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State
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Zip
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Phone
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Email Address
Missions Experience
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List all mission trips you've been on in the last 5 years & what you did on those trips.
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What leadership positions have you held within you school/youth group?
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Why do you think you would make a great summer intern?
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If chosen, what would you hope to gain from the experience?
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List any unique/special gifts that you feel like you posses (music, leadership, etc.)
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List your strengths & weaknesses?
Summer Positions
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Which Position Are You Applying For?
Site Director
Intern
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Choose the locations where you prefer to serve.
Atlanta, GA
Birmingham, AL
Puerto Rico
Mexico
Guatemala
Romania
Kenya, Africa
South Africa
Philippines
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Do you speak another language? If so, what?
List 2 Personal References (1 must be a minister)
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First Name
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Last Name
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Phone Contact
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Email Address
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First Name
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Last Name
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Phone Contact
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Email Address
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Indicates Response Required