Rush Campus Ministries

SERVANT EADERSHIP APPLICATION

First Name: _____________________ Last Name: ______________________ Summer 2012 Address Address: _________________________________________________________ City: __________________ State: _________________ Zip: _______________ Home phone: ___________ Cell Phone: ____________ E-Mail: _____________ School Address2012-2013 Address: _________________________________________________________ City: __________________ State: __________________ Zip: ______________ Home phone: ___________Cell Phone: ______________E-Mail: ____________ Gender: __________ Year in School: __________ Date of Graduation: __________ Local Church: __________

1. Please give a brief summary of your testimony.

2. Describe how you are building intimacy with God on a daily basis.

RCM at UCA Conway, Arkansas 72035

Rush Campus Ministries

SERVANT EADERSHIP APPLICATION

3. What has God been teaching you lately?

4. How are you currently involved in ministry to others?

For the following questions, we want you to understand past problems with illegal drug use and/or immoral relationships will not prevent you from being accepted, provided: It can be determined that your current convictions are strong and consistent with Scripture. A significant track record of obedient Christian living has been established. If you answer yes to any of the following questions, please explain how you dealt with this area and what your current convictions are. We believe that Jesus Christ can and does change lives. Honestly answering these questions will not necessarily disqualify you from serving as a Servant Leader.

5. Have you had a voluntary sexual relationship with a member of the opposite sex? If yes, please explain. It is not necessary to share the details. Please let us know if it has occurred in the last 12 months and how you have dealt with it.

6. Do you consistently use alcohol and/or tobacco? If yes, please explain.

RCM at UCA Conway, Arkansas 72035

Rush Campus Ministries

SERVANT EADERSHIP APPLICATION

7. Have you ever used narcotics, hallucinogens, or illegal drugs not prescribed by a physician? If yes, please explain.

8. Have you ever been or are you now involved in a homosexual lifestyle? If yes, please explain.

9. Have you ever engaged in pornography? a. If yes, please explain.

b. If so, how often?

c. When was your most recent involvement with pornography?

d. What steps are you taking or willing to take to correct this problem?

10. Have you ever struggled with an eating disorder such as bulimia or anorexia? If yes, please explain.

a. What steps are you taking or willing to take to correct this problem?

RCM at UCA Conway, Arkansas 72035

Rush Campus Ministries

SERVANT EADERSHIP APPLICATION

11. Is there anything else of a personal nature you think is important for us to know about your life?

I understand that being a RCM Leader is a yearlong commitment. I agree to attend the RCM Leader training times. I understand that I will be evaluated by the RCM values I agree to operate under the vision of RCM. I agree to attend the RCM Leader Orientation in August. I agree to abstain from any behavior that would hinder Christian ministry. I understand that a breech of this contract will be cause for dismissal from being a RCM Leader.

Signature: ___________________________________ Date:_____________________

RCM at UCA Conway, Arkansas 72035