Fairfax Fellows Application Form

Name*

First Last

Address*

Street Address Address Line 2 City State ZIP Code

Email*

Cell Phone*

Denomination Affiliation*

How did you find out about the Fairfax Fellows Program?*

Fairfax Church

Online Job Board

Google Search

Other

Preferred ministry focus areas:

First Preference*

Second Preference*

Why are you interested in these areas of ministry?*

What specific experience have you already had in these areas?*

Education:

Enter information for current or past education.

Name of College/University*

Major*

GPA*

Year Entered*

Graduation Date*

Please briefly tell us about:

Your spiritual background and testimony.*

Someone who has influenced your life in an important way.*

Your family and your relationship with your parent(s) and any sibling(s).*

What you perceive are your greatest strengths and weaknesses.*

Your statement of belief regarding salvation and your relationship to God.*

Legal and Lifestyle Information

Are you using illegal drugs?*

Have you ever gone through treatment for alcohol or drug abuse?*

Have you ever been arrested and / or convicted of a crime?*

Have you ever had sexual relations with any minor after you became an adult?*

Are you living with someone of the opposite sex, to whom you're not married?*

Have you ever been accused or convicted of any form of child abuse?*

Have you ever been concerned that you may have an addiction to drugs, alcohol, pornography, or any other addiction, or or has anyone ever suggested that you may have a problem with any of the above?*

Have you ever been accused, charged, alleged to have or have you committed any act of neglecting, abusing, molesting, or battering any child or adult? Have you had any kind of a relationship with a minor that has brought sexual gratification to yourself?*

Have you ever been treated for a psychiatric disorder?*

Has there been any abuse in your family background with drugs or alcohol that was emotional, physical, or sexual in nature?*

Have you ever voluntarily left or been asked to leave a role within an organization or church due to a concern regarding inappropriate conduct with minors?*

Is there any circumstance or pattern in your life which would make it inappropriate for you to serve with minors or would you compromise the integrity of Fairfax Church?*

If you said yes to any of the above questions, please describe why below.*

Please also provide:

Resume*

Accepted file types: JPG, PNG, PDF. Maximum file size: 32MB.

Max. file size: 32 MB.

Current photo*

Accepted file types: JPG, PNG, PDF. Maximum file size: 32MB.

Max. file size: 32 MB.

Portfolio/Work Samples

Accepted file types: JPG, PNG, PDF. Maximum file size: 32MB.

Max. file size: 32 MB.

Other Work Samples/Social Media Handles

Please provide a website link (e.g. Youtube video, online resume, website). If providing a social media handle, please write your username and the associated social media profile (e.g. fairfaxcc on Instagram).

Reference 1

Name*

First Last

Position*

First Reference Email*

Reference 2

Name*

First Last

Position*

Second Reference Email*

Reference 3

Name*

First Last

Position*

Third Reference Email*

Agreement:

“I certify, to the best of my knowledge and belief, all the information provided or attached to this application is accurate, complete, and made in good faith. I also consent to Fairfax Church contacting my listed references.”

Name*

First Last

Date*

Comments

This field is for validation purposes and should be left unchanged.

FAIRFAX FELLOWS

APPLICATION FORM

We are excited that you are applying for a fellowship at Fairfax Church! If you are unable to complete the application in one sitting, please click the “Save and Continue Later” option to receive an email link to your application.

Preferred ministry focus areas:

Education:

Please briefly tell us about:

Legal and Lifestyle Information

Please also provide:

Reference 1

Reference 2

Reference 3

Agreement:

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