Cross-Cultural Worker CCW) ____ Short-Term Worker (STW) _____

NAME________________________________________________ DATE_____________

EMAIL_____________________________ PHONE#______________________________

ADDRESS_______________________________________________________________

CITY_________________________________STATE_____________ZIP CODE____

Occupation___________________________Major (if graduated from college)______________

Date commissioned as Volunteer staff_________________________Years at Mosaic_________

Current employment _________________________________________________________

Small Group Leader Name______________________________________________________

Ministry(s) currently serving in_____________________________________________________

Myers-Briggs___________________________________Spiritual Gifts__________________

Strength Finder results (top 5)____________________________________________________

Other Spoken Languages & Fluency? (if any) ________________________________________

For the CCW Applicant: (please answer on a separate sheet of paper)

• What significant leadership roles have you invested in over the past few years at Mosaic?
• Where are you planning to be deployed?
• When will you be deployed? Approximate month/year
• What agency are you being sent out with?
• How long are you intending to be overseas?
• What team will you be associated with on the field?
• What will be your role overseas?
• Have you been on an overseas Awaken Humanity project trip before? If yes, explain. (Include date, place, purpose of trip, what was your role with the team?)
• How has God spoken to you about going overseas?
• Share in a paragraph or two, when and how you became a follower of Christ and some significant events in your spiritual journey since.

For the STW Applicant: (please answer on a separate sheet of paper)

• What agency or company are you associating yourself with overseas?
• What will be your role?
• How long will be you overseas?
• What significant leadership roles have you invested in over the past few years at Mosaic?
• Have you been on an overseas Awaken Humanity project trip before? If yes, explain. (Include date, place, purpose of trip, what was your role with the team?)
• How has God spoken to you about going overseas?
• Share in a paragraph or two, when and how you became a follower of Christ and some significant events in your spiritual journey since.

Please have 2 Character References completed: Your Mosaic Team Leader & a personal friend who knows you well…

Name of Referral: ________________________________________________________________________________

(Person filling out this form for applicant)

* * * * *

Mosaic DEPLOY Character Reference Form for: ­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­

Reference Completed By:_________________________________ Phone: ______________________

Email: _______________________________ Signed/Date:_____________________________________________________

How long have you known this individual and in what context?

For each category, please check one response that best fits the individual that you are providing a reference for:

“For people that I know that have similar job responsibilities and experience, this person that I am providing a reference for ranks as follows in these categories:”