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“Called to Serve” is a service program sponsored by the Sisters, Servants of the Immaculate Heart of Mary of Monroe, Michigan. “Called to Serve” is open to college and post-college-age women.
The goal of the program is to offer young women the opportunity to:
- Serve those who are most vulnerable
- Study the issues that affect those we are serving
- Create community
- Pray together
Called to Serve – June 2-8, 2013
Application Form
Date
Name
Address
City
State
Zip code
Home phone
Cell phone
E-mail address
Work phone
Birth Date
What is your motivation for participating in “Called to Serve?”
What do you hope to gain from this experience?
What are your fears/and or questions about this experience?
What gifts do you bring to living with others in community?
Rate yourself on the following by using a scale of 1 to 5 with 5 being the highest:
Honesty and integrity _____ open-mindedness _____
Creativity _____ dependability _____
Maturity _____ health _____
Flexibility _____ self-confidence _____
Empathy _____ ability to communicate _____
Dealing with stress _____ sensitivity to other cultures _____
Emotional stability _____ integration of faith in daily life _____
Christian values _____ ability to get along with others _____
Sense of humor _____
Do you have any food, drug or environmental allergies? If yes, please explain.
Do you have special dietary needs? If so, please explain.
Do you have any physical challenges of which we should be aware? If so, please explain.
Will you be bringing a car? If so, what is your license number?
In case of emergency, please contact:
Name:
Address:
City, state, zip:
Phone (day):
Phone (evening):
Relationship:
Name:
Address:
City, state, zip:
Phone (day):
Phone (evening):
Relationship:
Education: (Begin with most recent):
College/ University Name:
City/State:
Major:
Year of Graduation:
College/ University Name:
City/State:
Major:
High school name:
City/ State:
Year of Graduation:
Two most recent work experiences, if any:
Job title/Description:
Employer:
City/State:
Dates:
Work phone
Dates
Job title/Description:
Employer:
City/State:
Dates:
Work phone
Dates
Two most significant volunteer experiences, if any:
Name of program or organization:
Volunteer position/ description of duties:
Dates:
Name of program or organization:
Volunteer position/ description of duties:
Dates:
References: Please send the attached reference form to two people who know you well enough to assess your character and abilities.
The program begins Sunday, June 2 with registration at 12:30 p.m. and concludes after lunch on Sunday, June 8. It is necessary to be present for the whole week.
Please email your completed application to Sr. Mary Bea: mbkeeley@ihmsisters.org
Any questions or concerns? Email or call Sr. Mary Bea 734-240-9820 (office) or 248-943-3408 (cell).
____________________________________________________________________________________________________________
“Called to Serve” is a service-learning program sponsored by the Sisters, Servants of the Immaculate Heart of Mary of Monroe, Michigan. “Called to Serve” is open to college and post-college-age women.
The goal of the program is to offer young women the opportunity to:
- Serve those who are most vulnerable
- Study the issues that affect those we are serving
- Create community
- Pray together
“Called to Serve” June 2-8, 2013
Personal Reference Form
Applicant’s name: __________________________________________________
To the person providing the reference: Thank you for taking time to provide a reference for the young woman applying to “Called to Serve”, a service learning week with the IHM sisters of Monroe, Michigan. Your responses will assist us in this process. If you have any questions, please call (734-240-9820 – office or 248-943-3408- – cell). You can also email Sr. Mary Bea at mbkeeley@ihmsisters.org.
How long and in what capacity have you known the applicant?
Character portrait: On a scale of 1 to 5 (5 being the highest) please rate the applicant according to the following qualities. You may also choose “not known.”
Honesty and integrity _____ open-mindedness _____
Creativity _____ dependability _____
Maturity _____ health _____
Flexibility _____ self-confidence _____
Empathy _____ ability to communicate _____
Dealing with stress _____ sensitivity to other cultures _____
Emotional stability _____ integration of faith in daily life _____
Christian values _____ ability to get along with others _____
Sense of humor _____
Describe the applicant’s personality, commenting on at least two of the traits above.
Comment on the applicant’s work or study skills if known.
Comment on the applicant’s interpersonal skills and her potential for community living.
Comment on the applicant’s spiritual life.
Do you have any reservations about this applicant?
Any additional comments?
Your contact information:
Name
Address
City, State, Zip
Work phone
Cell phone
E-mail address
