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Counseling Internship Application

First Name

Last Name

Phone Number

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Address

Please list the places and dates of degrees received.

High School

College

Graduate Level

How would you describe your relationship with God?

Describe the reason(s) as to why you would like to work in a Christian setting.

What do you hope to gain from working in a Christian counseling environment?

How do you see counseling in relation to the Christian ministry?

Do you have any other experiences in teaching or counseling in a Christian-related environment? If yes, please explain.

Which Julianna Poor Memorial Counseling Center site(s) are you interested in working at?

The Loop — Mon–Fri — 7401 Katy Fwy, Houston, TX 77024 Cypress — Mon & Wed — 11011 Mason Rd, Houston, TX 77433 Sienna — Tue & Thurs — 4309 Sienna Pkwy, Missouri City, TX 77459

Do you currently have a job or plan to have a job during your internship that affect the hours you are available to see clients?

Ministry Related Reference

Name

Phone Number

Other References

Name

Phone Number

Name

Phone Number

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Baptist Faith and Message 2000 Agreement

I have read the Baptist Faith and Message 2000 and agree to counsel in a manner that is consistent with it.*

Baptist Faith and Message 2000

* Please contact Myles Schutte at Myles.Schutte@HoustonsFirst.org or Greg Curnutte at Greg.Curnutte@HoustonsFirst.org if you have any questions or concerns about this requirement.

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Form Entry

Counseling Internship Application

Please list the places and dates of degrees received.

Ministry Related Reference

Other References

Baptist Faith and Message 2000 Agreement