Intern Application

Period Available for Service (ie: 1/31/2021 – 12/1/2022)

How long are you interested in serving?

Have you been on a mission trip with Sixty Feet previously?

Yes

If Yes, When?

Who was the leader?

Personal Information

First Name

Middle Name

Last Name

Gender

Male

Female

Date of Birth

Mailing Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Primary Phone Number

Facebook profile

Twitter profile

Personal Information

Passport Status

In Good Standing – Doesn’t Expire for More Than 6 Months from Planned Return Date

Expired, Lost, or Unknown

Application is in Progress

Need To Apply

Name As It Appears on the Passport

Passport Number

Nationality / Place of Issue

Issue Date

Expiration Date

Personal Information

Current Occupation

Place of Work

Skills

Spiritual Involvement

What is your Denominational Affiliation?

Are You Currently Involved in a Church?

Yes

How Long Have You Attended?

Pastor’s Name

Pastor’s Phone Number

Are You Currently Involved in a Small Group or Bible Study?

Yes

How Long Have You Attended This Group?

Leader’s Name

Leader’s Phone Number

Emergency Contact Information

Emergency Contact Name 1

Relationship To You – Contact 1

Primary Phone – Contact 1

Alternate Phone – Contact 1

Emergency Contact Name 2

Relationship To You – Contact 2

Primary Phone – Contact 2

Alternate Phone – Contact 2

Where are you interested in serving with Sixty Feet?

United States

Uganda

Other

Other Location

How did you hear about Sixty Feet internships?

Write out the Gospel in your own words.

Write out God’s salvation story in you including when you were baptized.

How is God currently growing you in your relationship with Him?

How are you currently sharing your faith? Please list specific examples of sharing your faith.

Why do you want to serve with Sixty Feet?

What qualities do you have that would make you fit for a foreign internship?

Are you willing to follow the authority of the Sixty Feet staff and/or representatives?

Yes

List all ministry involvement.

List any cross-cultural mission experience you have had and the duration of each trip.

Additional Questions

Note: Answering yes to any of the following questions does not necessarily disqualify you from serving with Sixty Feet. If you do answer yes to any of the following questions, please clarify in the box below that question.

Excluding minor traffic violations, have you ever been convicted of any violation of law or ordinance?

Yes

If Yes, Explain.

Have you ever been convicted of a crime (misdemeanor or felony)?

Yes

If Yes, Explain.

Have you ever been arrested or convicted for either physical or sexual abuse?

Yes

If Yes, Explain.

Do you have any physical impairments that prevents you from physical work or travel?

Yes

If Yes, Explain.

Have you been under the care of a counselor or mental health professional in the last 12 months?

Yes

If Yes, Explain.

Is there anything about your lifestyle that would potentially bring reproach on yourself, your family, Sixty Feet, or the name of Christ?

Yes

If Yes, Explain.

I have received and read, in it’s entirety, the Intern Information Package (IIP). I understand the nature of the intern position asit is described within the IIP, and desire to continue the application process. I agree with the Sixty Feet Guiding Principles anddesire to abide by it and other Sixty Feet regulations that may govern Sixty Feet interns in the present and in the future thatare not in opposition to Sixty Feet’s Guiding Principles. I also acknowledge that 3 Spiritual Reference Forms have beencompleted and are attached to and made a part of this Intern Application.I agree to allow Sixty Feet to share my personal information with affiliates and third parties for purposes such as obtaining abackground check. Sixty Feet will never sell your information or use it to profit or exploit anyone.I agree to allow Sixty Feet to release sensitive and/or personal information and medical information to my emergencycontacts if Sixty Feet deems necessary. By placing your initials here, you agree to this statement.

Sixty Feet Internship Application

Personal Information

Personal Information

Personal Information

Spiritual Involvement

Emergency Contact Information

Additional Questions

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