Maison Internship Application
Please email a photo to missions@forhisgloryoutreach.org. Have your pastor AND a teacher/mentor complete the reference form also listed on the website.
Full Name (as printed on passport)
First Name
Last Name
Preferred Name
First Name
Last Name
Age
Gender
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Phone Number
-
Area Code
Phone Number
E-mail
Marital Status
Church Information
Name of your Home Church
Church Denomination
Lenght of time at Home Church
Senior Pastor's Name
E-mail
Youth/Other Pastor's Name
E-mail
Church Phone Number
-
Area Code
Phone Number
Church Website
Emergency Contact Information
Contact Full Name
First Name
Last Name
Relation to You
Cell Phone Number
-
Area Code
Phone Number
Phone Number
-
Area Code
Phone Number
E-mail
Your Missionary Support
Each Maison Intern is required to raise his or her own support. There are currenlty no scholarships available. Please email missions@forhisgloryoutreach.org for more information on the cost of the trip.
Are you able to personally cover the cost of an internship?
Please Select
Yes
No
If not, how do you plan to raise the necessary funds?
Prayer Support
It is essential that you have people who are covering you in prayer.
We suggest that you have a minimum of 5 Prrayer Warriors who have committed themselves to intercede and pray for you, for your ministry, and for the people of Haiti. Write the names of 5 people that will be praying for you during your internship.
Christian Life and Calling
Describe your conversion experience and your present relationship with the Lord.
Why do you want to serve as an Intern at Maison?
Experiences, Education and Talents
Describe your academic education:
List your talents, abilities, and gifts that can be useful in the ministry:
List your weaknesses and the areas in which you need to grow:
What ministries have you been involved in within your church community? Include lenght of time and specific duties:
Explain your relationship to your Church community:
Identify and describe any overseas travel and purpose. (vacation, schook, missions, etc...)
Identify and leadership roles that you have been assigned. (sports, academic, on mission trips, church, etc...)
What language do you speak? List the languages and describe your proficiency:
Past History and Personal Information
All information is kept completely confidential. We will not deny acceptance based solely on past histroy, but we need to be aware of potential struggles.
Have you ever had or do you currently have problems in any of the following areas?
Drugs
Alcohol
Pornography
Sexual Sin
Depression
Eating Disorder
Experiences with the occult
Financial Debt
Problems with authority
Cheating in academic settings
Please describe the current condition of your heart concerning any checked areas from above.
Describe your reputation; how do you think others see you?
How do you respond when things don't work out as you had planned?
How do you usually respond to the correction of others in your areas of weakness or when you make a mistake?
How do you work in stressful situations? Identify two high stress situations tha you have experienced.
How do you respond in a situation of conflict between you and another person?
Personal Evaluation
Read each pair of phrases. Pick the one that is most descriptive of you.
Please choose one:
Please Select
Compulsion to work
Slow to put out effort
Please choose one:
Please Select
Challenge authorities
Very submissive
Please choose one:
Please Select
Focus on needs of others
Focus on own needs
Please choose one:
Please Select
Not flexible
Flexible
Please choose one:
Please Select
Very emotional
Stable emotional responses
Please choose one:
Please Select
Punctual
Late
Describe your comfort level in being assertive and giving directions, reprimands, and praises to peers:
Describe your comfort level in being assertive and giving directions, reprimands, and praises to people that are older than you:
Medical History
Please list any allergies, surgeries, or major diseases that you have had:
Please list current medications that you take on a regual basis:
By signing below, I affirm that the above information is true and accurate to the best of my knowledge.
Please Select
Yes
No
Signature
Date
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Submit
Should be Empty: