Mentor Application All TruthGirlz mentors are trained and supported by Crossroads Care Clinic Staff. Complete online form and submit.(Or download and email to truthgirlzmentoring@truthgirlz.org, fax (704) 872-0380, or drop off at Crossroads Care Clinic @1710 Davie Ave.) Today's Date * MM DD YYYY Name * First Name Last Name Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Email * Phone * (###) ### #### Can we text you at this number? * Yes No Date of Birth * MM DD YYYY Marital Status * Single Married Divorced Widow EMPLOYMENT BACKGROUND Employer Occupation How long? Hours of Employment Full Time Part Time Flexible MINISTRY EXPERIENCE List relevant experience in ministry, volunteer service, or educational. Name and Length of Service Name and Length of Service Name and Length of Service TRAINING AND GIFTS What spiritual gifts, talents or personality traits do you bring to this ministry? * CHRISTIAN WALK Do you consider yourself to be a Christian? * Yes No If yes, please explain what it means to be a Christian. * Briefly share your salvation experience. * What habits and disciplines are currently helping you mature in your Christian walk? * What church do you attend? * Pastor's Name * First Name Last Name Church Phone (###) ### #### Describe your involvement at your church? * GENERAL INFORMATION How did you hear about TruthGirlz? * What is your reason for getting involved with TruthGirlz? * Core Values * Please check each statement to demonstrate that you are in agreement with Crossroads Care Clinic's Core Values and Statement of Faith. I believe that life begins at conception and matters deeply to God. I believe that sexual intimacy is a gift from God and honors Him when enjoyed in marriage. I believe the Bible to be the inspired, infallible, authoritative Word of God. I believe there is one God, eternally existent in three persons: Father, Son, and Holy Spirit. I believe in the Deity of our Lord Jesus Christ, in His virgin birth, in His sinless life, in His miracles, in His vicarious and atoning death through His shed blood, in His vodily resurrection, in His ascension to the right hand of the Father, and in HIs personal return in power and glory. I believe that for the salvation of the lost and sinful man, regeneration by the Holy Spirit is absolutely essential, and that this salvation is received through faith in Jesus Christ as Savior and Lord and not as a result of good works. I believe in the present ministry of the Holy Spirit by whom indwelling the Christian is enabled to live a godly life and to perform good works. I believe in the resurrection of both the saved and the lost; they that are saved uto the resurrection of life and they that are lost unto the resurrection of damnation. I believe in the spiritual unity of believers in our Lord Jesus Christ. REFERENCES Please provide one each Pastoral Professional, and personal reference. Pastoral Reference Name * First Name Last Name Email * Phone * (###) ### #### Professional Reference Name * First Name Last Name Email * Phone * (###) ### #### Personal Reference Name * First Name Last Name Email * Phone * (###) ### #### APPLICANT'S CERTIFICATION AND AGREEMENT I certify that the fact set forth in this application are true and complete to the best of my knowledge, and I authorize the Crossroads Care Clinic to verify their accuracy and to obtain reference information on my work performance and character. I further certify that I have read and that I am in full agreement with the Crossroads Care Clinic's Statement of Faith and Statement of Principles. TruthGirlz Mentoring is an extension of the Crossroads Care Clinic of 1710 Davie Ave, Statesville, NC 28677. Applicants signature of agreement * Date * MM DD YYYY Where do you feel most led to help us. Check all that apply. * TruthGirlz Middle School Mentor (Afternoons 3:30-5:30; every week) TruthGirlz High School Mentor (Durning the day before 3:00pm every week) TruthGirlz Boutique (As needed) Prayer Team TruthGirlz Other If other, specify where. Thank you for stepping out to serve in this vital ministry. We will get in touch with you soon. Blessings, TruthGirlz Staff
