Application for

Дата канвертавання24.04.2016
Памер39.36 Kb.

BRIDGES Missions Program

Connecting to the World through Missions Partnerships”



An Initiative of the North Georgia Conference of the United Methodist Church

In partnership with United Methodist Volunteers In Mission (UMVIM)

May 24th – August 6th

(Dates are approximate, and will be finalized in March)

Rev. Blair Boyd Zant

Uganda BRIDGE Internship Coordinator

86 Mt. Vernon Hwy

Sandy Springs, GA 30328

Hard Copy must be submitted to this address on or before due date of JANUARY 27TH, 2012 for application to be considered. Please save an electronic copy of all responses as a back up to your submission.
Date __________________
I. INTRODUCTION: COMPLETE ALL PARTS OF THIS APPLICATION (including attachments) and retain a hard copy for your records. Additionally, please save an electronic copy of this application for email forwarding purposes. Read the entire document before answering the questions.
LAST NAME: ____________________ FIRST NAME: __________________ MIDDLE NAME:______________
LOCAL ADDRESS STREET: ____________________________________________________________________
CITY: _______________________ STATE: ________ ZIP CODE: _______________
PHONE: _____________________ E-MAIL: ______________________________________
PASSPORT #________________________________________ EXPIRATION DATE: ___________________
GENDER: M_____ F_____ BIRTH DATE: _________________________
US CITIZEN*: YES _____ NO______ Do you have health insurance? YES _____ NO _____
ETHNIC ORIGIN: White_______ Black_______ Hispanic_______ Asian or Pacific Islander_______
American Indian or Alaskan Native_______ Other (list) _____________________________
MARITAL STATUS: Single ____ Married ____ If engaged, wedding date ______________________

Spouse's full name: ___________________________________________________________________

Spouse's occupation _____________________________ No. of children _______Ages_____________

Are you interested in your spouse traveling with you? YES ______ NO ______

Spouses wishing to travel internationally must cover all of their travel and living expenses. Have you

considered the implications of this? YES ______ NO ______

Current Occupation ______________________________ Employer __________________________________
Please Note: As this internship program is designed to bolster the covenant relationship between the North Georgia Conference and East Africa Annual Conference of the United Methodist Church, applicants must demonstrate current membership and participation in the North Georgia Conference, and/or intention to serve God through the United Methodist Church in North Georgia in the immediate future.
Are you a United Methodist? YES _______ NO _______
Do you currently hold church membership in a local United Methodist church in North Georgia?)

YES _______ NO _______

Church Membership
NAME: _____________________________________________________

ADDRESS: _____________________________________________________

CITY: _____________________ STATE: __________ ZIP: ____________

PHONE: _____________________ FAX: ___________________ EMAIL: ________________________

Where do you currently attend church? Same as above listed _____
Or, NAME: _____________________________________________________

ADDRESS: _____________________________________________________

CITY: _____________________ STATE: __________ ZIP: ____________

PHONE: _____________________ FAX: ___________________ EMAIL: ________________________

Educational Status

Are you currently enrolled in a undergraduate, graduate, or seminary degree program? Y ____ N _____

If yes, Full Time ______ Part-Time ______ Less than part time ______
Undergraduate Degree/Program: __________________________________________________________________

College/University: _____________________________________________________________________________

Completed _____ In Progress _____
Graduate Degree/Program ________________________________________________________________________

College/University: _____________________________________________________________________________

Completed ______ In Progress _____
Seminary Degree/Program _______________________________________________________________________

Seminary/Divinity School: _______________________________________________________________________

Completed ______ In Progress _____
For “In Progress” degrees: At the conclusion of this semester, how many courses/hours will you have completed?

____ out of ____ required for graduation.

Will you hope to receive academic credit for your participation in this internship program? YES ____ NO ____
PREVIOUS Field Education/Contextual Education experiences:
1. ________________________________________________________________________
2. ________________________________________________________________________
3. ________________________________________________________________________
Are you seeking denominational ordination? YES_____ NO______

Ordination / Candidacy status:

Inquiring Candidate ___

Certified Candidate ___

Provisional Elder ___

Provisional Deacon ___


Please note your present ministry and vocational interests: Of the following areas of church and community ministry and development, what four areas are of most interest to you: (Please rank them in order of interest, 1-4, 1 being “most interested”)

Local Church Ministry ____ Campus Ministry ____ Education ____ Medicine _____ Rural Ministry____

Urban Ministry ____ Missions____ Institutional (School/Hospital) or Military Chaplaincy ____ Business _____

Law ____ Christian Education ____ Diaconal Ministry____ Agricultural Development _____ Preaching _____

Church or School Administration _____ New Church Development ____ Pastoral Care _____ Evangelism ____

Social Work _____ Counseling _____ Sports and Recreation _____ Fine Arts (Art, Music, Drama) _____
Other (please explain) __________________________________________________________


The BRIDGES Mission Partnerships strive to strengthen the world wide United Methodist Church by creating partnerships between conferences to create relational opportunities for dialogue, discipleship, and Christian service. Through the Uganda BRIDGE Internship Program, young adults will be afforded the opportunity to engage in vocational discernment and spiritual formation by living and working alongside Ugandan brothers and sisters within three designated “tracks” of service. Each track will be shaped to the specific gifts and interests of the intern, as well as to the changing needs and learning opportunities that develop on-site.

  1. Church Ministry Track,

Interns will assist with the further development and growth of United Methodist Churches in EAAC’s Mukono or Jinja Districts. Interns will have the opportunity to participate in preaching, evangelism, Christian education, church development, outreach, pastoral care, and local church administration. Under the supervision of the local church pastors, District Superintendents, Conference Staff, and the Bishop of East Africa, interns will experience the blessings and challenges of local church development and leadership in Uganda.

  1. Christian Education Track,

Supervisor, Esther Nabwire, Headmistress of Humble United Methodist School, Mukono, Uganda
Interns will work side by side with School administrators and teachers at HUMBLE United Methodist School. This unique school is sponsored by several UM Conferences in the United States, and provides a safe educational environment for vulnerable children. While most of the students are Ugandan, some also come from Rwanda, Sudan, Democratic Republic of Congo, and Burundi. Interns may assist with office administration, work with and develop recreational, art, music, and/or drama programs, and assist as school chaplains, leading chapel services and devotionals for students.

  1. Agricultural Sustainability Track

Supervisor, Esther Nabwire, Headmistress of Humble United Methodist School, Mukono, Uganda
Interns will assist with the new agricultural initiatives at HUMBLE United Methodist School. Through hands-on experience cultivating, planting, tending and harvesting HUMBLE School’s new fields and gardens, Interns will be afforded opportunities to reflect on the ways that agricultural sustainability can positively affect communities, and where such initiatives cross-sect with Scripture and discipleship. This particular track could easily overlap with either of the other two, leaving room for additional participation in the life of the school, and/or the local church.


For questions 2-4, please attach your responses to this application, or type them into the document below. Should not exceed a total of 4 pages. Remember to save a copy of your responses in MS Word Document format. If you are applying for more than one track, please answer each question separately for each track, and then answer Question 5 as well.

  1. Please indicate which placement settings you are applying for: (You may apply for more than one.)

_____ Church Ministry Track

_____ Christian Education Track

_____ Agricultural Sustainability Track

  1. For each track to which you are applying, please attach a narrative (1-2 pages) explaining why you would like to be placed in that setting. Please include an explanation of what impact you feel such an opportunity would have on your own faith development and vocational discernment.

  1. Have you done any coursework, participated in any activities, or participated in any travel that has heightened your understanding of Uganda, or other transitioning countries in the third world?

  1. How might an international placement contribute to your emerging vocational identity?

  1. If you are interested in applying for more than one track, in what ways might you envision integrating the two tracks?

  1. Will you be under any restrictions for health or medical reasons? If so, please describe in detail.

  1. Are you required to take medication regularly? YES_____ NO_____

If yes, what is the medication and what are the conditions under which it should be administered?

8. Must your diet be restricted for health or other reasons? YES_____ NO_____

If yes, please describe those restrictions.
9. The coordinators of this program will be working at the local church and conference levels in hopes of raising funds to help offset the total cost of this program. However, are you willing to fundraise to cover both programmatic and personal expenses that will arise from your participation? YES_____ NO_____
I covenant to faithfully fulfill the service and learning opportunities of my placement insofar as my abilities permit with the support of the North Georgia and East Africa Annual Conferences, and the Uganda BRIDGE Internship Program Coordinators. My signature authorizes the release of this application to the Board and supervisor.
Furthermore, in addition to the expectations of the BRIDGES Internship Program, I will work diligently to fulfill any requirements asked of me by my college/university/seminary program in order to secure any academic credit I seek through successful completion of this program.
Finally, with God’s help, I covenant to faithfully represent my Lord, church, conference, country, and self as I serve humbly: committed to listen before speaking, learn before teaching, demonstrate respect for all those I encounter, and embody the love of Christ in my thoughts, words and actions.
Signed _______________________________________
Name: _______________________________________
Date: _______________________________________

* Upon receipt of completed application materials, applicants will be contacted by a member of the BRIDGES Board to undergo an initial interview. Invitations to a final round of interviews will be issued in early February, and those interviews will take place in mid-February. Invitations for the internship positions will be extended in early March. Participants who accept will receive additional information about United Methodist Volunteers In Mission training sessions and trip preparation. On behalf of the entire BRIDGES team, thank you for your interest in this life-changing ministry and service opportunity.

Grace and Peace,

Rev. Blair Boyd Zant

Uganda BRIDGES Internship Coordinator
VII. VITA: (Please provide us with the following information. You may also submit a resume that includes the following information.)
1. LAST Name _____________________________ FIRST Name _______________________ M.I. ____

2. Educational Experiences (post-high school):
Institution Degree Year Area(s) of concentration
a. __________________________________________________________________________________________

b. __________________________________________________________________________________________

c. __________________________________________________________________________________________
3. Extra-curricular Activities (explain, if necessary):
4. Church Experience (where, offices held, paid positions, special experiences, etc.)

5. Work Experience (part-time and full-time employment of whatever kind during and following college; explain if necessary)

6. Special skills you may have developed through church, educational or work experiences (for example, musical, athletics, drama, organizational-management, etc.)

7. Hobbies and/or special interests (including significant travel experiences)

8. Do you speak any foreign languages? What language(s)?

Please provide us with the contact information for three (3) individuals that you feel would provide an honest and insightful assessment of your character, vocational aspirations, and preparedness for this kind of international immersion experience. We recommend speaking with them first, so that they are prepared to speak candidly, but thoughtfully about you when contacted. No immediate family members, please.
Church Reference: (Pastor/Campus Minister/Faith Community Leader)

Name: _________________________________________ Title: _________________________

Name of Church/Ministry: ________________________________________________________

Phone Number: _______________________ Email: ___________________________________

Mailing Address: _______________________________________________________________

Street City State Zip
Academic Reference: (Academic Advisor/Professor)

Name: _________________________________________ Title: _________________________

Position/Employer: _____________________________________________________________

Phone Number: _______________________ Email: ___________________________________

Mailing Address: _______________________________________________________________

Street City State Zip
Character Reference: (Friend, co-worker, etc.)

Name: _________________________________________ Title: _________________________

Relationship to Applicant: ________________________________________________________

Phone Number: _______________________ Email: ___________________________________

Mailing Address: _______________________________________________________________

Street City State Zip

Uganda BRIDGES Summer Internship Program

Connectional Ministries Office

North Georgia Conference of the United Methodist Church

Criminal Records Check Application
I,______________________________, hereby authorize the North Georgia Conference of the United Methodist Church (NGC of the UMC) and/or its agents to receive any criminal history record information pertaining to me which may be in the files of any state or local criminal justice agency in Georgia.
I release NGC of the UMC and/or its agents from any and all liabilities, claims or law suits in regards to the information obtained from sources used.
The following is my true and complete legal name and all information is true and correct to the best of my knowledge.


Full Name (Printed)

Maiden name or Other Names Used


Present Street Address How Long?


City/State Zip Code


Phone Email Address

_______________ ________ _______ ____________________

DOB Sex Race Social Security #

_________________________ ____________________

Driver’s License # State of Issuance

_________________________________ ____________________

Applicant’s Signature Date

_________________________________ ___________________

Notary’s Signature Date

Name: _______________________________

Page of 6

База данных защищена авторским правом © 2016
звярнуцца да адміністрацыі

    Галоўная старонка