Field Mentor Application Field Mentor Application Step 1 of 2 50% General InformationInternship Site:*Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code APO-AEArgentinaAustraliaAustriaBahamasBahrainBrazilBulgariaCameroonCanadaChileChinaColombiaCosta RicaCyprusCzech RepublicDemocratic Republic of the CongoDominican RepublicEcuadorEnglandEritreaEthiopiaFranceGambiaGermanyGhanaGuineaGuyanaHaitiHondurasHong KongIndiaIndonesiaIsraelItalyJamaicaJapanKenyaLiberiaMacedoniaMalawiMalaysiaMexicoMyanmarNepalNew ZealandNicaraguaNigerNigeriaNorwayPakistanPanamaPapua New GuineaPeruPhilippinesPolandRomaniaRussiaSierra LeoneSingaporeSouth AfricaSouth KoreaSpainSt LuciaSwazilandSwedenSwitzerlandTaiwanTanzaniaThailandTrinidad and TobagoUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesVenezuelaVietnamZambiaZimbabwe 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 ApplicationPlease 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 TitleEmail 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. BA in Biblical Studies BA in Business Administration BA in Children's Ministry BA in Christian Ministry BA in Communication Studies BA in Intercultural Studies BA in Philosophy BA in Preaching Ministry BA in Psychology BA in Spiritual Formation & Ministry BA in Worship Ministry BA in Youth & Family Ministry 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.):Add Another Application or Complete?If you would like to add another Field Mentor Application, select the "plus" sign to do so. If you are finished, click "Submit & Finish" to complete.