Community internship Parent/Guardian Form

All information gathered through the screening process will be handled confidentially.

Internship Applicant First Name

Internship Applicant Last Name

Parent/Guardian First Name

Parent/Guardian Last Name

Parent/Guardian Phone Number

Parent/Guardian Email

Parent/Guardian Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Church Currently Attending

Pastor's Name

Has the applicant discussed or counseled with you concerning his/her interest in participating in the Community Internship program?

What do you understand is the motive for the applicant wanting to participate in the program?

What are the applicant's greatest strengths?

Has the applicant had any serious problems in submitting to parental or other authority?

Do you fully approve of the applicant participating in the Community Internship program?

Thank you for completing the Community Internship Parent/Guardian Form. This is an invaluable resource as we consider the applicant. Please feel free to add any additional comments that may be helpful.

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