FUI Application

This application is lengthy and must be completed in one sitting. If you are unable to do so, please contact the director at tminturn@fiful.org to request a hard copy which can be filled in by hand.

Description
Fresno Urban Internship is a five-week experience that places participants with agencies and churches working in various aspects of urban ministry. Participants contribute approximately 30 hours per week to their agency, five hours per week to internship classes, and 5 hours per week in study. Students live in community together in the Pink House. Arrangements for meals are arrived at by agreement with the other interns. The overall program is intensive, rigorous, and challenging, as well as joyful and fun.
 
Fees/Finances: The Internship Program costs $800.00, which covers rent, food, incidentals, books, materials and supervision. Send a deposit of $100.00 to the address provided below. Make checks or money orders payable to InterVarsity. Deposit must be postmarked by May 1st. The remaining $700.00 is due upon arrival.
 
Mailing Address:

 
InterVaristy-FUI
310 N. Roosevelt Ave.
Fresno, CA 93701

Terms of Release
1. In consideration for being accepted and allowed to participate in this conference/project and activities associated with its program and location, I personally assume responsibility for my actions, and release InterVarsity Christian Fellowship/USA® (hereafter InterVarsity®), its Trustees, employees and agents from loss, injury or damage to myself or my property; provided that nothing contained herein shall excuse InterVarsity, its Trustees, employees or agents from responsibility to act with reasonable care for the safety of myself or my property.

 
2. I give permission to InterVarsity to be photographed, recorded, and/or video taped and to allow this material to be used for publicity.
 

3. I give permission to InterVarsity to obtain medical assistance in the event of an emergency. This permission will include the administration of medicines, surgical treatment, X-ray examination or hospitalization as might be ordered by a licensed medical doctor. I release and discharge InterVarsity, its trustees, employees, and agents from any liability for any first aid rendered or treatment performed pursuant to this consent.
 

4. I understand that InterVarsity has a hostage policy that states that InterVarsity should not yield to demands, including the payment of ransom or other extortion, issued through the use of hostage taking or extortion.
 

5. If I am under age 18 (if you are, please check here ), I state that I am a mature minor of college age and living away from parent/guardian and have the capacity to consent to the terms of the Release.
 

6. Any claim or dispute arising from or related to this release shall be settled by mediation and if necessary, legally binding arbitration in accordance with the Rules of Procedure for Christian Conciliation of the Institute for Christian Conciliation, a division of Peacemaker® Ministries (complete text of the Rules is available at www.HisPeace.org). Judgment upon an arbitration decision may be entered in any court otherwise having jurisdiction. I understand that these methods shall be the sole remedy for any controversy or claim arising out of this release and expressly waive my right to file a lawsuit in any civil court against InterVarsity for such disputes, except to enforce an arbitration decision.
 

7. Additionally, in applying for this internship, I pledge to fulfill the following:

 
a. To be willing to be part of this experience by retaining a flexible and non-complaining spirit and be open to new things. To work with staff in making the internship a success. To evaluate it afterward to help future interns have a better experience.
 

b. To put in the agreed upon number of hours per week with the agency with which I've been placed for at least five weeks, and to work hard as unto the Lord. See the website for an overview of the agencies listed below, and then check one or more of the boxes below to indicate which agencies you would be interested in (available agencies subject to change).

 
Economic Opportunity Commission’s Transitional Living Center

Evangel Home

Fresno Interdenominational Refugee Ministries

Fresno Rescue Mission
Fresno Street Saints
Hope Now For Youth
Light & Life Urban Ministries
Reading and Beyond
World Impact

Youth for Christ's City Life
 

Placement Disclaimer: Although most interns will be placed with one of their top three choices, available agencies are subject to change, and ultimately the director makes the final decision regarding placement.

 
c. To submit to the guidance and policies of the agency and/or supervisors with whom I am placed, the director of the internship, and the consensus of the other interns.

 
d. To meet weekly at specified times with the other interns and to go through the agreed upon curriculum and any related assignments. To be prepared for these meetings.

 
e. I understand that I will be living in community either at the Pink House or some other designated housing option. I will be flexible with regard to my placement and living arrangements.

 
I certify that I have read the above paragraphs and am competent to submit this release, and have done so voluntarily.

Gender (select one): Male Female
Name
Street Address
Apt.
City State Zip
Home Phone
Cell Phone
Email Address
T-Shirt Size

School
Declared Major
Year in School (i.e. Soph)

Ethnicity
 
Emergency Contact Information
Name
Street Address
Apt.
City State Zip
Phone
 
Parent or Guardian Information

(if different from Emergency Contact Information)
Name
Street Address
Apt.
City State Zip
Phone

Personal Reference

(pastor, InterVarsity staff, employer who knows you well)
Name
Phone

Email Address
 

Participant’s College or Health Insurance Policy Information
Company Name
Policyholder Name
Policy Number

Do you have any medical concerns we should be aware of (if yes, please explain)?

Are there any physical or emotional limitations that may require special consideration (if yes, please explain)?

Are you currently under the care of a physician? If so, please explain and provide the name and phone number of your physician.

List any prescription medications being taken.

Are you currently taking medication or under a doctor’s care for depression (if yes, please explain)?

Have you at any time in the last 3 years attempted suicide (select one)? YES NO
Do you have any allergies or medical conditions we should be aware of to avoid problems and to assure proper emergency action?

Do you have any food restrictions that we should be aware of to avoid problems?

Do you speak another language? If so indicate the language:

Many of the sites require the use of a vehicle. Do you have a car in good working order that you can bring (select one)? Yes No
Are you open to others using your car (select one)? Yes No
How long have you been a Christian? What experiences have most shaped your Christian life?

What is your interest in urban mission? Why do you want to be considered for this internship? What are some things you hope to learn?

Your participation in this project should affect the quality of your ministry back on campus. How will your campus fellowship or community benefit from your participation in it?

What cross-cultural experiences have you had and how have these changed you?

Briefly explain your understanding of and participation in racial reconciliation.

While participating in the internship this summer your focus will be fully consumed by your responsibilities. Interns are asked not to plan any trips away for the duration of the internship. Also, there is only one day designated for visitors. There are no overnight accommodations for guests. Do you perceive any problems with this? If so, please explain.

In order to enhance the experience this summer we ask that interns agree to limit the use of their electronic communication devices, including cell phones and laptop computers. These limitations will be explained once you arrive. Are you able to live within these guidelines?

This internship involves taking a class that includes multiple reading assignments, lectures, and class discussions. Interns are expected to complete all the reading and engage in class discussions.
Is there anything that will hinder you in this?

What are some of your strengths and weaknesses that might be relevant to this project?

Of these agencies (EOC Transitional Living Home, Evangel Home, Fresno Interdenominational Refugee Ministries, Fresno Rescue Mission, Fresno Street Saints, Hope Now For Youth, Light & Life Urban Ministries, Reading and Beyond, World Impact, and Youth for Christ's City Life) which would be your first choice for ministry and why (your actual placement will be determined by the director)?

What would be your second choice?

By entering my full name below, I understand that I am voluntarily submitting this information and submitting to its terms.

Full Name

Today's Date