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Name *
Name
Address *
Address
Phone *
Phone
If married, is your spouse in favor of participation with Momentum?
Date of Birth *
Date of Birth
Will you have reliable transportation while serving in the Momentum Internship/Apprenticeship Program? *
SPIRITUAL HISTORY
Are you born again? *
Have you been baptized in the Holy Spirit? *
Do you speak in tongues? *
Have you ever served in a ministry before? *
PERSONAL HISTORY
We believe in living morally pure, which would include being free from pornography, sexual relationships outside of marriage, and vices such as gambling, smoking, drinking and addictions. Please be honest & forthright in answering the following questions. A YES will NOT automatically disqualify an applicant from acceptance. We simply must know where applicants are as we pray into their applications.
Do you smoke? *
(Including any type of vape, hookah or cigars etc.)
Do you drink alcohol? *
Do you use non-prescription/illegal drugs? *
Have you ever been arrested? *
Have you been convicted of any crimes? *
Have you ever been involved in immoral sexual relationships? *
Have you ever been involved in a same sex relationship? *
Have you ever been involved in the occult, witchcraft or cults? *
HEALTH
If None, just type "None".
EDUCATION
High School - Graduated/GED: *
College/University - Graduated *
EMPLOYMENT
Are you a student? *
Will you be taking a leave of absence from your job or school to attend the Momentum Internship/Apprenticeship Program? *
PASTORAL REFERNCE
Please provide the name, phone number, and email address of your pastor so we may contact them with some reference questions. If your pastor is your parent or spouse, please provide the name of another member of your church's pastoral staff. If you do not currently have a pastor please provide the information of someone that is currently a Pastoral role in your life.
Pastor's Full Name: *
Pastor's Full Name:
Pastor's Phone Number: *
Pastor's Phone Number:
PERSONAL REFERENCES
Each applicant is required to submit two personal references. Please provide the names, email addresses and phone numbers of the persons we may contact with some reference questions.
#1 Full Name: *
#1 Full Name:
Phone Number: *
Phone Number:
#2 Full Name: *
#2 Full Name:
Phone Number: *
Phone Number:
#3 Full Name:
#3 Full Name:
Optional
Phone Number:
Phone Number:
SHORT ANSWER
MINISTRY INTERESTS
Please check your Top 3 Ministry Areas: *
WAIVER
I hereby agree that, while attending the Momentum Ministries Internship/Apprenticeship Program and serving with Annie Byrne in any and all capacities, I understand and accept the fact that I am hereby providing complete indemnification and waiver of liability and I undertake to save harmless and indemnify Momentum Ministries from any and all liability, actions, suits, proceedings, demands, assessments, losses, judgments or costs, legal actions or all expenses related to any injury or loss that I may sustain as a result of any attendance at an orientation, outreach, event, administrative work, yard work, media work, resource work, or being billeted or as a result of involvement in any street missionary work. I attend events and participate in all of the above-mentioned events, doing so at my own risk, being responsible for my own finances, safety, and well-being. I am not an employee of Momentum Ministries and assume all liability for any loss personal property or personal injury while attending the Momentum Ministries Internship/Apprenticeship Program and serving with Momentum Ministries.
Have you read the Waiver Statement above? *
Do you agree to the Waiver Statement above? *
Please type in your Full Name: *
Please type in your Full Name:
Have you had a chance to read this entire document including all questions and statements? *
Please Note:
Momentum Ministries reserves the right to require the withdrawal of any person serving in the Momentum IA Programs who is considered to be out of harmony/agreement with the spirit of this ministry at any time during the Program.