MEV Application 1Program2Agreement3General Info4Education & Work Experience5Personal Background6Spiritual Background7Financial & Visa Information8Volunteer Duties9Statement of Faith10References11Academic Advisor or Professor12Sign Which program are you applying for?* Mission Experience Volunteer (MEV) - 6 months Mission Experience Volunteer (MEV) - 1 year Study Abroad Missionary (SAM) - Summer (May - July) Study Abroad Missionary (SAM) - Fall (August to October) Study Abroad Missionary (SAM) - Winter (February - April) Requested Start Year* Mission Experience Volunteer Program Application*This application is for a Mission Experience Volunteer (MEV) term with FICM. An MEV is considered to be an unpaid volunteer with FICM. Should your volunteer application be accepted, you will be assigned on loan as a volunteer to our Partner Organization located in a foreign country – An Tobar Nua (ATN), an Irish Revenue Commission recognized charity. FICM and ATN are Partner Organizations. ATN is located in Galway City, Republic of Ireland. The Partner Organization is responsible for and agrees to provide housing, work uniform (if required) and some meals per week for the assigned Volunteer, and for assigning tasks and responsibilities to the Volunteer. Due to the nature of the work of MEVs with FICM and ATN, which is primarily focused on youth and students, and the challenges of living in community in a foreign country, some of the questions on this application may seem personal, but are necessary for assisting us in getting to know you and understand your aptitude for the work. There are no incorrect answers or answers that will result in automatic rejection of your application. I Agree Study Abroad Missionary Program Application*This application is for students who have applied for and been accepted by their university to be a Study Abroad Missionary (SAM) with FICM or students seeking a practicum experience as part of their degree studies. A SAM is considered to be an enrolled student at their university, who will be assigned to study and participate in certain ministry techniques and practices at our Partner Organization located in a foreign country – An Tobar Nua (ATN), an Irish Revenue Commission recognized charity. FICM and ATN are Partner Organizations. ATN is located in Galway City, Republic of Ireland. ATN is responsible for and agrees to provide housing, work uniform (if required) and some meals per week for the SAM, and for assigning and supervising tasks and assignments given to the SAM. Due to the nature of the work of SAMs with FICM and ATN, which is primarily focused on youth and students, and the challenges of living in community in a foreign country, some of the questions on this application may seem personal, but are necessary for assisting us in getting to know you and understand your aptitude for the work. There are no incorrect answers or answers that will result in automatic rejection of your application. I Agree General InformationFull Name* First Middle Last Preferred Name Birth Date*Day12345678910111213141516171819202122232425262728293031Month123456789101112Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Permanent Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Mailing Address Same as Permanent Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Phone*This is my:* Home Phone Mobile/Cell Phone Email* How did you hear about this program?*Requested Start Date*Choose...Fall (mid-July start)Spring (mid-January start)Do you have a current passport?* Yes No Education & Work Experience:High School*Name of SchoolCityStateGraduation Date or Expected Graduation Date College/University Name of Institution Degree Type (eg. BSA, BSC) Actions Edit Delete There are no Colleges/Universities. Add College/University Maximum number of colleges/universities reached. Previous Work Experience Company Name Location Role or Title Actions Edit Delete There are no Work Experiences. Add Work Experience Maximum number of work experiences reached. Personal BackgroundWhat are your top three personal strengths?*What are your top three weaknesses/development areas?*What do you believe are your ministry strengths/giftings?*What specific areas of your ministry would you like to see developed or improved?*What is your attitude towards and experience with building cross-cultural relationships?*Marital Status*Choose...SingleMarriedIn a RelationshipDivorcedWidowedDo you use, or have you used, tobacco products?*Choose...Yes, currentlyYes, previouslyNoHave you ever abused alcohol or been in treatment for alcoholism*Choose...Yes, currentlyYes, previouslyNoPlease describe your current state of recovery.*Do you have a history of or are you currently struggling with an eating disorder?*Choose...Yes, currentlyYes, previouslyNoPlease describe your current state of recovery.*Have you ever struggled with prolonged depression, strong anxiety, self-harm, or thoughts of suicide in a way that has affected your ability to do your job or school work?*Choose...Yes, currentlyYes, previouslyNoPlease describe your current state of recovery.*Have you ever used any narcotics or other drugs not prescribed by a physician, or have you ever or are you currently using prescription drugs beyond the dosage prescribed by a physician?*Choose...Yes, currentlyYes, previouslyNoPlease describe your current state of recovery.*Have you ever been arrested or convicted of a felony?*Choose...YesNoPlease explain.*Do you have any health issues that you would like to make us aware of that may impact your ability to perform certain tasks or which require ongoing medical attention?*Is there anything else about your interests, talents, skills, or personality that you would like to share with us? Spiritual BackgroundPlease describe your personal faith journey and how you came to know Jesus personally.*Where do you attend church currently? Name of Church Actions Edit Delete There are no Churches. Add Church Maximum number of churches reached. Describe how you pursue spiritual growth and what God has been teaching you. Please include the frequency and amount of time you spend with the Lord.*Describe your past ministry involvement and training (evangelism, discipleship, Bible studies, conferences, short term missions, etc)*Describe any involvement with professional groups, clubs, or community organizations (religious or otherwise).*Describe any leadership positions you have held in ministry, your community, or in other activities.*What is your understanding of and attitude toward “relationship evangelism”?*Are you willing to be trained in relationship evangelism?*Choose...YesNoAre you comfortable working with Christians from various spiritual backgrounds and denominations?*Choose...YesSomewhatNo(Optional) Please explain your answer. Financial & Visa Information By completing this application, you are applying to serve as a Mission Experience Volunteer (MEV or Volunteer) for FICM. MEVs are loaned as a volunteer to our Partner Organization, An Tobar Nua, which is located in a foreign country (ATN). The Partner Organization is responsible for and agrees to provide housing, work uniform (if required) and some meals per week for the assigned Volunteer, and for assigning tasks and responsibilities to the Volunteer.*If accepted, I understand that I will be serving as a Mission Experience Volunteer for FICM who will be loaned as a volunteer to a Partner Organization (ATN). I understand that I will not be considered an employee or subcontractor, and that I will not receive any wages or compensation for my assigned work as a Volunteer. I understand that I will be assigned tasks by the Partner Organization, and that it will be my responsibility to undertake such tasks to the best of my ability. I further understand that these tasks are assigned and supervised by the Partner Organization, and that the execution of such tasks does not change my Volunteer relationship with FICM, and that failure to execute such tasks as assigned by the Partner Organization may result in immediate termination of my Volunteer arrangement with FICM, termination of my visa sponsorship by the Partner Organization, and being asked to return home from the Partner Organization location. I Agree *If accepted, I understand that I will be ultimately responsible for any required visa applications which are necessary for me to be assigned to a Partner Organization in another country. I understand that it is not the responsibility of FICM to determine my eligibility for a visa, and that such authority rests solely with the government of the specified country. I Agree *I further understand that if I my visa application is denied, that I am not entitled to any compensation or refund of any kind from FICM or the Partner Organization, and that any funds raised and donated towards my living expenses cannot be legally refunded or returned to the donors or me. I Agree *If accepted, I am aware that I must raise my own financial support to cover my additional living expenses while assigned to the Partner Organization and that FICM is not responsible for my expenses above that amount which I have raised. Such additional living expenses include, but are not limited to, my off-hours meals, incidental spending needs, clothing, travel, and any other such needs as they occur. I understand that this list is not meant to be fully inclusive of the needs of any individual living in a foreign country, but is meant to clearly define the limit of FICM and the partner organization’s responsibilities. I Agree Are you currently in financial debt?*Choose...YesNo Description of Expected Volunteer Duties (An Tobar Nua Section)*This application is for a Mission Experience Volunteer term with FICM. An MEV is considered to be an unpaid volunteer with FICM. Should your volunteer application be accepted, you will be assigned on loan as a volunteer to a Partner Organization (ATN). This section describes the expectations of An Tobar Nua (ATN), an Irish Revenue Commission recognized charity. FICM and ATN are partner organizations. ATN is located in Galway City, Republic of Ireland. I understand *For visa entry requirements, you are required to provide your own health insurance and to pay for any uncovered medical needs, including but not limited to medications, dental, emergency care, and transportation. Insurance coverage can also be purchased in Ireland through our group insurance plan at an additional cost. I understand *This application is for a Study Abroad Missionary term with FICM. This section describes the expectations of An Tobar Nua (ATN), an Irish Revenue Commission recognized charity. FICM and ATN are partner organizations. ATN is located in Galway City, Republic of Ireland. I understand *You are required to provide your own health insurance and to pay for any uncovered medical needs, including but not limited to medications, dental, emergency care, and transportation. I understand *If accepted, I am aware that I must provide my own financial support to cover my additional living expenses while assigned to the Partner Organization and that FICM is not responsible for my expenses above that amount which I have raised. Such additional living expenses include, but are not limited to, my off-hours meals, incidental spending needs, clothing, travel, and any other such needs as they occur. I understand that this list is not meant to be fully inclusive of the needs of any individual living in a foreign country, but is meant to clearly define the limit of FICM and the partner organization’s responsibilities. I Agree Are you willing and able to serve and learn with ATN considering the conduct expectations?*SAMs are considered to be fully enrolled at their university, and subject to all requirements regarding conduct and behavior of their university regardless of being off-campus from their home university. Your university’s requirements may be more lenient than those requested of you by ATN/FICM. You are expected to adhere to the more conservative requirements. We try to live in such a way that no one will be hindered from finding the Lord by the way we act, and so no one can find fault with our ministry. (2 Corinthians 6:3 NLT) Recognizing that team members represent Christ, and as Christians are called by His name, we should represent His name well, wearing it with joy. The staff and SAMs of ATN represent the Organization, but more importantly represent Christ Himself. With the thought ever in our minds that our work is unto the Lord, we will expect that each of us will handle our responsibilities and duty coverage in a manner pleasing to Him. This extends to the social media presence of SAMs while on site with ATN. All efforts will be made to accommodate personal needs as they arrive, keeping in mind the teamwork needed to keep the facility running smoothly. SAMs at ATN are requested to serve and learn in the following areas: Serve willingly with a positive attitude in all areas of ministry with ATN, including (but not limited to) the An Tobar Nua Café, An Tobar Nua Youth Outreach, Bothar Emmaus Bookshop, Emmaus Scripture School, An Tobar Nua Counselling Centre Serving in all requested aspects of The Retreat by An Tobar Nua as part of An Tobar Nua Youth Outreach. This includes retreats held in the An Tobar Nua facility and local schools, as well as on travelling retreat teams. Living a Christian life in a community setting. Living in community involves an attitude of inclusion, an attitude of involvement, commitment to service to one another, a commitment to meaningful active investment in relationship with other team members, and a commitment to “pulling your weight” in community responsibility (such as cleaning duties). Agreeing to live by the ATN Life in Christ Principles. SAMs agree to not partake of alcoholic beverages, smoking or use of illegal drugs during their time of ministry with ATN. Furthermore, attendance in bars, nightclubs, and pubs that cater to these activities is strongly discouraged, especially due to the nature of the ministry’s work and role modeling to young people. A lifestyle consistent with Biblical standards for sexual purity is expected. No pornography is permitted in any form. No alcohol, smoking, or illegal substances are permitted anywhere in the ministry buildings, property or any houses or apartments owned or leased by ATN. Language and conversation should reflect the light of Christ. No profanity or crude joking will be allowed. Likewise, unkind joking or teasing does not convey the love of Christ and no form of bullying or sexual harassment will be tolerated. Dress should be appropriate and modest. Uniforms, when required, are provided and expected during assigned work hours. Workers are expected to abide by the laws of the country at all times. Workers must maintain discipline in areas of personal Bible study, cleanliness, timeliness, and lifestyle. All areas of life should reflect ongoing growth in the Lordship of Jesus Christ. Agreeing to attend church regularly, in alliance with my denominational background. Agreeing to participate in a missions experience. I understand that I will be serving and learning during the week and that specific time off during the week is predetermined by ATN leadership. SAMs agree to arrive on site in time to begin tasks or classes at the requested time, and to work until released from their requested assignments or classes. Serving in the interdenominational ministry consisting of Christians from multiple church denominational backgrounds, including Catholics and non-Catholics. Agreeing that breaking these expectations for Christian life, service, ministry and community life may result in disciplinary actions, my visa sponsorship being terminated and being asked to return home. Further, any issues arising related to conduct which is not consistent with the written expectations of your university and/or ATN/FICM will be reported to your home university. I Agree Are you willing and able to volunteer in requested capacities by the Partner Organization?* Yes No Optional CommentsExplain how and why you believe that God is calling you to this mission experience in the Republic of Ireland.* Statement of FaithFICM Mission, Foundational Values, and Beliefs*I have read and agree with the FICM Mission, Foundational Values, and Beliefs. View the FICM Mission, Foundational Values, and Beliefs. I have read and agree Please include 3 references. *References should NOT be your parents or immediate family members* Reference 1: Spiritual Mentor Reference 2: Former (or current) employer Reference 3: Other Reference (from someone who knows you well and can attest to your character) References Name Phone Email Actions Edit Delete There are no References. Add Reference Maximum number of references reached. Academic Advisor or ProfessorName* Dr.MissMr.Mrs.Ms.Prof.Rev. Prefix First Last College or University Name* Department or College* Email* Phone I certify that I am 18 years of age or older at the time of this application submission. To the best of my knowledge, the information contained in this application is true and complete. I authorize FICM to make such inquiries are may be necessary in arriving at an acceptance decision, which includes contacting the people completing my references. I hereby release those persons from all liability to inquiries in connection with my application.Name* First Last Signature*NameThis field is for validation purposes and should be left unchanged. Δ