Multiplying Laborers for the Urban Harvest

A p p e n d i x

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The Urban Ministry Institute Equipping Leadership for the Urban Church

Volunteer Application for Professor or Mentor

A professor is an Institute instructor who develops and/ or implements courses, teaching classes, tutoring students, and leading seminars and conferences that fulfill the goals of your Institute.

Name ___________________________________________________

Date __________________________________________________

Home phone __________________________________________________

Business phone __________________________________________________

Home address __________________________________________________

City, State, Zip __________________________________________________

A mentor is an Institute instructor who facilitates and/or assists the learning experience of the students in their taking of courses, classes, seminars, and conferences that fulfill the goals of your Institute.

Birth Date __________________________________________________

E-mail __________________________________________________

Employer name __________________________________________________

Employer address __________________________________________________

City, State, Zip __________________________________________________

In case of emergency, notify __________________________________________________ Relationship __________________________________________________

Address __________________________________________________

City, State, Zip __________________________________________________

Phone __________________________________________________

Name of the church you attend __________________________________________________ Address __________________________________________________

City, State, Zip __________________________________________________

Phone __________________________________________________

Denominational affiliation, if any __________________________________________________ Are you a member of this church? __________________________________________________ What is your role in your church? __________________________________________________

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