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I-Quest Application Form

General Information

Applicants First Name

Current Phone

Applicants Last Name

Permanent Phone

Applicants Nickname

Best Time to Reach You

Best Phone Number to Call

Date of Birth

Current Address

Age

Permanent Street

Gender

Parent Name

Church Name

Parents' Phone Numbers

Denomination

Emergency Contact Name

U.S. Citizen

Emergency Phone

Marital Status

Emergency Person Relation

Education Information

GPA

Year Graduated

High School

College/University

School Name

Degree/Major

Minors

Extra Curricular Activities

Will You Receive Credit For This Internship

What Department

References

Ref1_Name	Ref2_Name	Ref3_Name
Ref1_relation	Ref2_relation	Ref3_relation
Ref1_Street	Ref2_Street	Ref3_Street
Ref1_City	Ref2_City	Ref3_City
Ref1_State	Ref2_State	Ref3_State
Ref1_Zip	Ref2_Zip	Ref3_Zip
Ref1_Email	Ref2_Email	Ref3_Email
Ref1_Phone	Ref2_Phone	Ref3_Phone

Autobiography

Why have you chosen to be part of this program?

Do you have any ministry experience?

What are your three greatest passions?

Who is God to you?

Please, describe how you came to know Jesus Christ:

Do you have a regular devotional time?

Describe your activity in church:

What has God been teaching you lately?

Define your understanding of discipleship and servant hood:

What are your strengths and weaknesses:

What changes would you like to see take place in your own life?

Background Information (check all that apply)

Expelled:

Fainting spells:

Detention:

Eating disorder:

Convicted of Crime:

Breathing problems:

Involved with tobacco products:

Psychiatric care:

Involved with alcohol:

Depression medication:

Involved with illegal drugs:

Premarital sexually active:

Involved with gang related activities:

Pregnant or fathered a child:

Involved with a cult or the occult:

Taken medication for behavior:

Diabetes or hypoglycemia:

Physical limitations disabilities:

Seizures of any kind:

Thirty pounds or more overweight:

Personal Struggles (check all that apply)

Dishonesty:

Workaholic:

Loneliness:

Embarrassment:

Moodiness:

Inability to make friends:

Excessive guilt:

Negativity or criticalness:

Impulsiveness:

Abuse of alcohol or drugs:

Impatience:

Feelings of rejection:

Smoking:

Occult involvement:

Discouragement:

Prejudice or intolerance:

Excessive worry:

Sexual thoughts or pornography:

Being cocky:

Suicidal thoughts or attempts:

Being domineering:

Stealing or kleptomania:

Rebelliousness:

Violence, anger or arguing:

Stress or tension:

Homosexual feelings or activity:

Bulimia or anorexia:

Confusion or hopelessness:

Inability to take a joke:

Attention Deficit Disorder:

Sexual or physical abuse:

Exclusive or absorbing infatuations:

Sexual or physical abuse:

Motivational Gifts Assessment: Part A

Read each work pair and decide which characteristic most closely resembles your actual behavioral style.
Example: 1 - Forthcoming, 2, 3, 4 - Private

Select #2 indicates that you are "Forthcoming", but not as "Forthcoming" as a #1 would indicate.

Select #3 indicates that you are "Private", but not as "Private" as a #4 would indicate:

Expressive<->Reserved

Relationship<->Task Oriented

Spontaneous<->Calculated

Gregarious/Warm<->Aloof /Cool

Unorganized<->Organized

Impulsive<->Discriminating

Close<->Distant

Relaxed<->Self-Controlled

Unstructured<->Structured

Trusting<->Skeptical

Intuitive<->Logical

Lenient<->Strict

Available<->Unavailable

Inconsistent<->Disciplined

Personal<->Impersonal

Sympathetic<->Reasonable

Friendly<->Reserved

Feeling<->Thinking

Casual/Easygoing<->Orderly/Precise

Tolerant<->Exacting/Meticulous

Unconventional<->Conventional

Like to Work with Others<->Work Alone

Random<->Methodical

Guided by Inspiration<-> by Facts

Demonstrative<->Undemonstrative

Motivational Gifts Assessment: Part B

Initiating<->Yielding

Firm<->Flexible

Self-Reliant<->Supportive

Decides Quickly<->Contemplates

Pioneering<->Comfortable

Eager<->Patient

Risking<->Careful

Outspoken<->Reflective

Enjoys Change<->Enjoys Routine

Takes Charge<->Takes Direction

Direct/Tactful<->Subtle/Tactful

Pushy<->Reticent

Makes Statements<->Asks Questions

Insistent<->Conforming

Dominating<->Compliant

Acts<->Ponders

Confirmative<->Avoids Conflict

Outgoing<->Introspective

Talks<->Listens

Demanding<->Accommodating

Out in Front<->Behind the Scenes

Forceful<->Receptive

Competitive<->Cooperative

Extrovert<->Introvert

Challenges<->Agrees

Pick the Column Below that Best Describes You (A, B, C, D):

A	B	C	D
Courageous	Out going	Kind and Nice	Precise
Firm	Active	Encouraging	Proper
Strong willed	Playful	Caring	Law-abiding
Bold and Brave	Fun-Loving	Thoughtful	Calculative
Dearing	Delightful	Content	Analytical
Convinced	Pleasant	Humble	Conservative
Decisive	Trusting	Loyal	Flexible
Risk Taking	Enthusiastic	Peaceful	Careful and Cautious
Adventurous	Hipper and Energetic	Obedient	Perfectionist

Summarize your relationship with your immediate family:

What do your parents think of you becoming a member of this program?

Whom in your life do you admire or look up to the most?

How do you intend to raise financial and prayer support for your trip?

If you are not accepted into this program what will you do this summer?

I agree with the terms:

Applicants Initials:

Date of Agreement:

Date: