HOLY TRINITY MONASTERY ASSOCIATE

APPLICATION FORM


Name __________________________________________

 


Present Address Permanent Address (if different)
____________________________________________ ____________________________________________
____________________________________________ ____________________________________________
Phone # _____________________________________  

Phone # ____________________________________

 

Email Address _________________________________________________________________________________
 

Age ______             Date of Birth ___________

Sex:         Male _______           Female ______
Marital Status: ___ Single   ___ Married   ___ Widowed   ___ Divorced/Separated  
Religious affiliation ______________________________________________________________________________

Contact in case of emergency _________________________________________________________________________________

Address________________________________________________________________  Phone#____________________________

Parents:

Father's name ____________________________________ Mother's name ______________________________________
Father's address 
_________________________________________________
Mother's address 
___________________________________________________
_________________________________________________
___________________________________________________
Phone # _____________________________ Phone # _________________________________

Education: list  name of school, address, dates attended, major, degree(s) or certificate(s).
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
Describe any additional education or training received

________________________________________________________________________________________________

________________________________________________________________________________________________

     
How did you hear about the Holy Trinity Monastery Associates program?
 
____________________________________________________________________________________________________________
:List the service activities in which you have participated over the past five years.

 

 

___________________________________________________________________________________________________________
 

Employment experience: List three relevant work experiences, beginning with the most recent. Please give name of the 
employer/institution, title or responsibilities and dates of employment.

1.__________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
2.___________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
3.___________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
List the skills you have acquired that may be useful in your ministry.
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________

     
Do you have experience with an other volunteer program? Which one?
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________

 

Have you ever lived "in community" (with a group who shared common interest, responsibilities, etc.)?
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________

 

Have you ever been convicted of a felony or a misdemeanor crime? _____ yes   ___ no.
 If yes, please explain on a separate sheet of paper.
Do you drive a car?      ___ yes   ___ no                  Do you plan to bring a car?      ___ yes   ___ no
Health:
1. Check (x) in the one item that best describes your present physical health:
a. (  )  in excellent health, fine physical condition.
b. (  )  in normal good health
c. (  )  in fair health, occasionally sick
d. (  )  in somewhat poor health, sick rather frequently
e. (  )  coping with some illness, under medical supervision

Are there any positions or circumstances in which you are unwilling to serve?

______________________________________________________________________________________________________

_______________________________________________________________________________________________________

When are you interested in coming to Holy Trinity Monastery and for how long?

1st Choice _________________________________________________________________________________________________

2nd Choice _________________________________________________________________________________________________

 

 

References - please list three persons whom you've asked to complete your references. They should currently know you well, be in a position to judge your general character, motivation, employment record, and evaluate your qualification for HTM Associates program.

Name  _________ _______________________________________________________

Address   ______________________________________________________________

City/State/Zip____________________________________________________________

 

Phone ______________________

Email ______________________

Name ______________ ___________________________________________________

Address _______________________________________________________________

City/State/Zip ___________________________________________________________

 

Phone_______________________

Email _______________________

Name ______ __________________________________________________________

Address ______________________________________________________________

City/State/Zip __________________________________________________________

 

Phone ______________________

Email _______________________

   
Comments:

 

 

I certify that to the best of my knowledge the information in this application is true

Signed ______________________________________________         Date __________________________