Field Mentor Application

Please place a check by the statements that reflect the situation as a potential Field Mentor. Do not check a box unless the statement is true for the potential Field Mentor. Please complete a separate application for each potential Field Mentor. Please read carefully.

Name

First Last

Title

Email

Select the area this mentor is seeking an intern in below. The area selected must match the intern's degree area and the mentor's current job/position.

Character

I will model integrity in all situations.

Education

I have earned a minimum of a bachelor's degree.

List your educational qualifications (specific degree earned, name of school, and year earned):

Please select at least one:

Experience - I have at least five years of experience since completing my bachelor's degree in a field related to the students primary reponsibilities in the internship.
Training - I have had prior supervisory experience/training as a mentor.
Or, I have not had prior experience/training but I am willing to participate in mentor training provided by LCU.

If you selected "Experience" in the previous question, please state experience qualifications (places of experience, title/responsibilities, and number of years of experience at each location):

If you selected "Training", please list prior experience/training as a mentor:

Continuing Preparation

I am willing to continue to prepare myself by participating in continuing education activities such as conferences, seminars, reading programs, etc.

Time

I am willing and able to meet with the student in a formal setting at least one hour per week for in-depth reflection, evaluation, and advising. This is in addition to time spent in working activities with the student.

PLEASE NOTE: This is an educational and ministry preparation internship. By checking the above box, the mentor understands that if he or she does not have the time to adequately mentor a student or intern, then he or she should NOT apply to be a Field Mentor.

Reporting

I agree to complete and return the intern's Monthly Reflection Reports, as well as the Midway Progress Report and Final Evaluation on time. I will also meet with the faculty mentor during pre-scheduled, on-site visits.

Philosophy of Mentoring - Why do you want an intern? Describe your philosophy of mentoring (why do you want an intern, how you plan to mentor an intern - methods, your level of involvement throughout the internship, etc.):

Field Mentor Application

Step 1 of 2

General Information

Permission Request

The Internship/Mentoring Context

Intern Benefits

Internship Time Frame

Qualification of Mentors

Add Another Application or Complete?

Please place a check by the statements that reflect the situation as a potential Field Mentor. Do not check a box unless the statement is true for the potential Field Mentor. Please complete a separate application for each potential Field Mentor. Please read carefully.