Applicant's Name

First Name

Last Name

Applicant's Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Sex

Male

Female

Birthdate

YYYY

Age

Civil Status

Married

Single

Divorced

Separated

Dating

Spouse Name

First Name

Last Name

Church you attend:

How long have you attend your church?

Are you a church member?

Yes

In what church activities/responsibilities have you been involved?

Name of church staff member that knows you best:

First Name

Last Name

Church Position

Church Staff Member's Email

Church Staff Phone Member's Number

(###)

###

####

Character Reference

First Name

Last Name

Character Reference Phone Number

(###)

###

####

Character Reference Email

Accompanying Minors (Children): List the nam, age, and sex of each child. Please indicate if children are traveling with you. If they are age fourteen (14) and older they will need to complete a separate application. Children under the age of fourteen (14) will need your supervision at all times.

If you attend school or college, please include where, grade/level, major and/or desired field of study.

Employment: company, name of supervisor, phone number, and your position

How would you describe your personal, physical, and mental health?

Are there any handicaps, allergies, or chronic diseases that could cause you difficulty?

Yes

If yes, explain:

Person we may contact in case of emergency:

First Name

Last Name

Relationship to you:

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Emergency Contact Phone Number:

(###)

###

####

How did you find out about Amani Baby Cottage?

In your own words write about yourself and why you desire to become a volunteer?

What contribution do you see yourself making as a volunteer?

Please write a short paragraph describing your experience in receiving Christ. If you are not a Born Again Christian, please write a short paragraph about your beliefs. The leadership at Amani Baby Cottage will review and determine whether to approve your application.

The ministry where you will work is based upon Conservative Christian Values. Will you be willing to submit under these Christian based rules, guidelines, and lifestyle during your stay? Please respond:

Please list if you have ever travelled/went on any mission trips or lived abroad for more than two months in another country?

Reference: Name and number of individual related to the above question.

Personal skills and hobbies/interests

If other, please explain:

Which month would you be most interested in coming to Amani?

What length of internship are you interested in?

Short-term: 6 weeks to 3 months

Mid-Term: 3 months to 6 months

Please specify your expected (estimated) length of stay:

Applicant's Facebook:

As a portion of the basis of approval, the applicant must list all types of social media in which you participate. Applicant must also grant the Volunteer Coordinator access into

http://

Applicant's Twitter

Applicant's Instagram

http://

Applicant's Linkedin

http://

Applicant's Blog

http://

Other

http://

Failure to openly invite Amani Baby Cottage into your Social Media spaces will disqualify the applicant from approval. I, the undersigned do hereby attest that all the above statements are true and accurate. I also understand that at any time if it is ever discovered that these statements are not true, my acceptance will be null and void without refund of any kind. Application Fee: The application fee must be paid before this application will be processed. By typing your name below you are agreeing to the terms and conditions.

Amani Intern Application

Amani Baby Cottage