Internship Application

MINISTERIAL INTERNSHIP APPLICATION FORM

*** PDSOM Updated 11/01/2022 *** This form MUST be filled out completely and submitted for approval PRIOR TO registering online for the class and beginning your internship. This form is to be completed together WITH your mentor.

Intern Information

Intern's Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email(Required)

Phone(Required)

Intern's Home Church(Required)

Pastor/Mentor Name(Required)

First Last

Check which level you are pursuing at this time:(Required)

Intern Signature(Required)

Date(Required)

Mentor Information

Pastor/Mentor's Name(Required)

First Last

Date(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email(Required)

Phone(Required)

Church Name Where Internship Will Be Performed(Required)

Church Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Are you currently credentialed with the Assemblies of God?(Required)

What level of credential do you hold?(Required)

As the mentoring pastor/coach I will meet with, pray with, encourage, correct, guide, and assist my intern to develop in the most Godly fashion, the character of a servant leader. I realize this will take time and effort on my part, as well as the intern's part. I further realize I will receive an Internship file to download and print out to use as a guide for the intern and I (Please print out a copy for yourself to keep.)(Required)

I agree

Ministerial Internship Application Form

MINISTERIAL INTERNSHIP APPLICATION FORM

Intern Information

Mentor Information

Intern & Mentor

PennDel School of Ministry - Internship Mentor Covenant

I recognize that the role of Internship Mentor is critical to the successful completion of the PDSOM internship and covenant with the student and PDSOM to carry out this responsibility to the best of my ability and affirm the following TEN statements:

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