Field Mentor Application Step 1 of 2 50% General InformationInternship Site:* Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaAPO-AEArgentinaArmeniaArubaAscension IslandAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia-HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongo, Democratic Republic ofCongo, Republic ofCook IslandsCosta RicaCote D'IvoireCroatiaCubaCuracaoCyprusCzech RepublicDemocratic Republic of the CongoDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEnglandEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFederated States of MicronesiaFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupe (Fr.)Guam (US)GuatemalaGuernseyGuineaGuinea BissauGuyanaHaitiHeard and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (North)Korea (South)KosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartinique (Fr.)MauritaniaMauritiusMexicoMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherland AntillesNetherlandsNew Caledonia (Fr.)New ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalQatarReunionRomaniaRussiaRussian FederationRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Tome and PrincipeSaint Vincent and GrenadinesSamoaSan MarinoSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican City StateVenezuelaVietnamVirgin Islands (British)Wallis and FutunaWestern SaharaYemenYugoslaviaZambiaZimbabweOther Country Internship Site Phone*Website Name of person completing this application:* First Last Position/Title:* Contact Person Email:* Permission RequestPlease check the box if the applicant(s) agree to the following: "I/we give Lincoln Christian University permission to publicize my/our contact information which will be listed after I/we have been approved as an Internship site. It is my responsibility to update information with the Internship Office as it changes." The Internship/Mentoring ContextPlease describe your ministry/business context in general (e.g location - urban or rural and size of ministry/business):*Please list what type of duties your intern would be performing:*Intern BenefitsIn addition to providing mentoring for the intern, we are planning to provide (check only the items that apply): Weekly honorarium Housing Meals Computer access Other Estimated weekly honorarium amount:*Housing Type:* How many meals:* All Some Occasional Describe other:* Internship Time FrameWe would like an intern during the following time frames (select all that apply): Fall Semester (September through December) Fall Semester plus summer (May/June through December) Spring Semester (January through April/May) Note: Graduating seniors must have all their academic and time (months and hours) requirements completed by May 1. Spring Semester plus (January through August) Summer only (for 4-hr Bi-vocational Missions) Yearlong If "Yearlong", specify desired time frame:* If you are seeking to be approved for, or have already made contact with a specific LCU student to be your intern, please list his/her name and the area he/she will be working in: First Last Area of Study:BA in Biblical StudiesBA in Business AdministrationBA in Children's MinistryBA in Christian MinistryBA in Communication StudiesBA in Intercultural StudiesBA in PhilosophyBA in Preaching MinistryBA in PsychologyBA in Spiritual Formation & MinistryBA in Worship MinistryBA in Youth & Family Ministry Qualification of MentorsPlease complete an application for each potential Field Mentor. Please be sure each person being submitted as a potential Field Mentor is qualified based on the seven qualifications. For example, if you are seeking a music intern then you need to have a full-time music minister as a mentor, not a preacher who used to do music ministry. If you want a youth intern, then you need a full-time youth minister to supervise a youth ministry intern, not a preacher who wants someone to do youth ministry, etc. We need qualified, full-time mentors in each field for our students.Submission of Qualified Field Mentors:* I will submit only qualified persons to be Field Mentors. They also know that I am submitting their names. I will be submitting the following number of applications for Field Mentors:*12345678910 Field Mentor Application Name 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 Education List your educational qualifications (specific degree earned, name of school, and year earned): Please select at least one: 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 Time Reporting 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.): Actions Edit Delete There are no Entries. Add Entry Maximum number of entries reached. Add Another Application or Complete?If you would like to add another Field Mentor Application, select the "Add Entry" sign to do so. If you are finished, click "Submit & Finish" to complete.