JOSEPH INTERNATIONAL

MARKETPLACE INTERNSHIP

APPLICATION

PERSONAL INFORMATION
Internship Dates: o January 23 - April 23, 2012 o May 28 August 10, 2012 Program cost*: o $2,490 OR o $1,950 and I have my own iPad *Payable upon internship start. If Joseph International is purchasing your iPad, all tuition is due at internship start. A three-month payment plan is available if intern has own iPad. *Application fee of $50 must be included with application. Name Street address City Home phone ( Email ) State Mobile phone ( Age Zip code )

LEGAL STATUS (please check one)

o o o o o US Citizen US national Legal permanent resident Legally present in the US Currently residing abroad Visa type:

FAMILY INFORMATION
Father/guardian Address Mother/guardian Address o Deceased City o Deceased City o Living Phone ( State o Living Phone ( State Zip Zip ) )

1. Marital status: o Single o Engaged o Married o Widowed o Separated o Divorced 2. If you are married, please answer the following: Spouses name Date of birth How long married?

Is your spouse attending the internship? o Yes o No If so, they must fill out a separate application. If not, please include a letter from your spouse with their Christian experience and their feelings about your time in the internship. 3. Do you have any children? o Yes o No If so, please list each child coming to Kansas City with you. *We do not provide childcare or childrens programs with this internship. How did you hear about the Joseph International internship?

EDUCATION, EMPLOYMENT, AND MINISTRY BACKGROUND

1. List senior high school and institutions of higher education you have attended, with the most recent first. School name City, State Dates attended Diploma/degree

2. List previous places of employment, with the most recent first Employer Phone ( Responsibilities Employer Phone ( Responsibilities Employer Phone ( Responsibilities City, State ) Supervisor Reason for leaving City, State ) Supervisor Reason for leaving City, State ) Supervisor Reason for leaving Dates

Dates

Dates

3. Do you have a police record? o Yes o No If so, please include details, dates, and outcomes on a separate sheet 4. Are you currently involved in a local church? o Yes o No If not, please explain on a separate sheet 5. List previous church involvement, with the most recent first. Church name, city, and state Dates Senior Pastor

6. Describe your previous ministry training and involvement. Use an extra sheet of paper if more space is needed.

7. Describe how your church or spiritual family feels about your time as an intern.

HEALTH INFORMATION
1. Have you ever voluntarily or involuntarily received help for psychological, sexual, emotional, or relational problems? o Yes o No If so, please provide details below Year Caregiver(s) Identified problem(s) 2. Do you currently have, or have you ever had, thoughts of harming yourself or others? o Yes o No If so, please describe

3. Are you currently, or have you ever, taken medication related to psychological problems? o Yes o No If so, please describe your treatment methods and medications

4. Are you currently on any medications? o Yes o No If so, please fill out the following medication disclosure.

MEDICATION DISCLOSURE
The Joseph International internship requires that, for the duration of any program enrollment, attendees maintain their prescribed regimen of medication unless directed to change under the supervision of a physician. Medication name For Dates Physicians name and phone

I, (printed name) agree to continue with the aforementioned medications throughout my time at the Joseph International internship, as prescribed by my physician. I realize that failure to maintain or manage my medications, as prescribed by my physician, will be grounds for my immediate dismissal. Signature Date

PERSONAL EVALUATION
1. Please assess yourself in the following areas: Spiritual maturity Devotion to Jesus Christ Integrity and honesty Openness to correction Self-discipline Working without supervision Willingness to serve Ability to work with others Communication skills Leadership skills Reliability Teachability Emotional stability Physical health Family life Uncertain [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] Weak [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] Good [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] Outstanding [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ]

Additional comments or explanations:

What would you consider to be your talents, gifts, and strengths? What would do consider to be your weaknesses or struggles? Do you plan on bringing a vehicle to the internship? o Yes o No If not, please explain transportation plans. Do you currently have any financial debt? o Yes o No If so, please explain your plans for managing it if accepted into the internship.

How do you plan on paying the full program cost?

Are you currently engaged or in a dating relationship? o Yes o No Please elaborate on this relationship and how it will be maintained during the internship.

AREAS OF INTEREST
1. In what area/industry are you currently studying or focusing? 2. Describe what aspect of the internship interests you the most. 3. Out of the following work areas below, which three are the most interesting to you? Physical wellness/fitness Music and production Advertising and sales Videography/video editing Writing/copywriting Design (graphic and layout) Photography Technological mechanics Acting/modeling Business/work-flow management *If none of the above options interests you, please fill in your own areas below (1) , (2) , (3)

4. To complete your required 20+ work hours during the internship, which of the following options are you considering? o A. Work hours with Joseph International (E-Magazine, admin, or Fit4 Gym) o B. Work hours outside of Joseph International (Must already be employed or have a specialized field requiring outside employment). Employer: Hours working per week: o C. Full-time school Name of school: 5. Describe your expectations for this internship and what you want to get out of these three months.

NEXT STEP:
Mail your completed application packet: o Have your pastor fill out the Pastoral Recommendation Form o Have your personal referee fill out the Personal Recommendation Form o Type your personal testimony on a separate document o Fill out the background check form for use by The Daniel Academy, which shares the Joseph International building Mail to: Joseph International Attn: Kris Edler 310 W. 106th St. Kansas City, MO 64114 o Please include application fee payment of $50 Record a five-minute video of yourself answering the questions described below and submit to info@josephinternational.org

PERSONAL TESTIMONY
Please write your personal testimony as a separate typed document. Include the following points in less than 2 pages: 1. A summary of your personal journey in Christ 2. Describe any past or present life-controlling issues, whether mental, emotional, or relational 3. Expectations for your time in the internship

VIDEO
Using your video camera, cell phone, or computer; please record a video in 5 minutes or less that answers the following questions: 1. What does your day-to-day relationship with God look like? 2. What are your personal and professional goals for the next 5+ years? 3. What is the most significant work-related or educational experience you have had and how will it impact your 5+ year goal? Email video clip to info@josephinternational.org with the following information in the subject line: name, internship application video.

LIVING IN KANSAS CITY

Your budget for your time in Kansas City must also include enough to cover your housing and food costs. You are responsible for finding your own accommodations, though Joseph International can help you locate housing if needed. You should be prepared to budget +/$300 per month for housing plus your food costs.

PASTORAL RECOMMENDATION FORM

To be complete by the applicant: Name Internship start date Phone ( Email o I do not waive my right )

o I waive my right to see this character reference

APPLICANT: This recommendation form is to be completed by your present or former pastor. If

your pastor is your relative, an elder or other church offer may act as pastoral reference. You may waive your right to see this character reference with the understanding that none of the information within will be disclosed to you. Check the circle above which best represents your wishes. Failure to indicate a choice is the same as checking I do not waive.

TO THE PASTORAL REFEREE: Please return this form directly to the applicant in a sealed
envelope so they may submit all components together as one packet. If you have any questions, please email info@josephinternational.org. Name Staff position Church address Contact phone Church name Church phone City, state, zip Email

1. How long have you known the applicant? How well do you know him or her? 2. Please describe the applicants level of involvement in your church. 3. What is the applicants effect on his or her peers? 4. The apprenticeship consists of a heavy weekly schedule. Do you foresee difficulties for the applicant with a schedule combining high expectations and extensive time constraints? 5. According to your observations, what are the strengths and spiritual gifts of the applicant?

6. According to your observations, what is your assessment of the applicants weaknesses and struggles? 7. Have you seen any complex family or relationship factors that might affect the applicants service at the Joseph International internship?

8. Please assess the applicant in the following areas.

Spiritual maturity Devotion to Jesus Christ Integrity and honesty Openness to correction Self-discipline Working without supervision Willingness to serve Ability to work with others Communication skills Leadership skills Reliability Teachability Emotional stability Physical health Family life

Uncertain [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ]

Weak [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] o No

Good [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] Why or why not?

Outstanding [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ]

9. Would you have the applicant on your staff? o Yes

10. Do you recommend this applicant for the Joseph International internship?
o Highly recommend o Recommend recommend* *Please explain. o Recommend with reservations* o Do not

Additional comments or explanations not already covered:

Signature

Date

PERSONAL RECOMMENDATION FORM

To be completed by the applicant: Name Internship start date Phone ( Email o I do not waive my right )

o I waive my right to see this character reference

APPLICANT: The recommendation form is to be completed by a person who is not in your

immediate family, but has known you well for a minimum of three years. You may waive your right to see this character reference with the understanding that none of the information within will be disclosed to you. Check the circle above which best represents your wishes. Failure to indicate a choice is the same as checking I do not waive.

TO THE PERSONAL REFEREE: Please return this form directly to the applicant in a sealed
envelope so they may submit all components together as one packet. If you have any questions, please email info@josephinternational.org. Name Address Phone Date of birth City, state, zip Email Age

1. How long have you known the applicant? How well do you know him or her? 2. What relationship do you have to the applicant?

3. Please describe your understanding of the applicants intentions for his or her time as an intern. 4. The internship consists of a heavy weekly schedule. Do you foresee difficulties for the applicant with a schedule combining high expectations and extensive time constraints?

5. According to your observations, what are the strengths and spiritual gifts of the applicant?

6. According to your observations, what is your assessment of the applicants weaknesses and struggles? 7. Have you seen any complex family or relationship factors that might affect the applicants service at the Joseph International internship?

8. Please assess the applicant in the following areas. Spiritual maturity Devotion to Jesus Christ Integrity and honesty Openness to correction Self-discipline Working without supervision Willingness to serve Ability to work with others Communication skills Leadership skills Reliability Teachability Emotional stability Physical health Family life Uncertain [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] Weak [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] Good [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] Outstanding [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ]

Additional comments or explanations:

9. Do you recommend this applicant for the Joseph International internship? o Highly recommend o Recommend o Recommend with reservations* o Do not recommend* *Please explain. 10. Do you support the applicants decision to move to Kansas City as an intern? o Yes o No Why or why not? Additional comments or explanations not already covered:

Signature

Date

AuthorizationandRequestforCriminalRecordsCheck Inordertoensurethesafetyforallofourinterns,andTheDanielAcademystudentswho
shareourbuilding,werequireabackgroundcheckonallapplicants. I,_______________________________(printname),herebyauthorizeJosephInternationalor TheDanielAcademy,torequestanylawenforcementagencyoranyotheragencychosenby Joseph International specifically for conducting this search, to release information regarding anyrecordofchargesorconvictionscontainedinitsfiles,oranycriminalfilemaintainedon me, whether local, state, or national, and including but not limited to accusations and convictionsorcrimescommittedagainstminors,tothefullestextentpermittedbylocal,state andfederallaw.Idoreleasesaidlawenforcementagenciesandanyotherentitiesfromall liabilitythatmayresultfromanysuchdisclosuremadeinresponsetothisrequest.
Printapplicantsfullname:

Printallothernamesthathasbeenusedbyapplicant(inany):

SSN(required)

Dateofbirth

Placeofbirth

CurrentAddress

PreviousAddress

Driverslicensenumber

Stateissuinglicense

Licenseexpirationdate

Daytimephone EmailAddress

ApplicantsSignatureanddate