Mentored Ministry Forms

To begin a rotation, complete and return the following:

  • Mentored Ministry Registration Form
  • Mentored Ministry Learning Covenant Cover Sheet signed by student and mentor
  • Mentored Ministry Learning Covenant
  • Ministry Rotation Supervisor Information (if supervisor is different than mentor)

When the rotation is finished, complete and return the following:

  • Evaluation Cover Sheet signed by student and mentor
  • Student Rotation Report
  • Mentor/Supervisor Evaluation of Student Rotation

Methods for form submission:

  • Mail: Gordon-Conwell—Jacksonville, 7235 Bonneval Rd., Jacksonville, FL 32256
  • Fax: 904-562-3313
  • Email: Coordinator of Mentored Ministry, jhiggins1@gordonconwell.edu
Registration Form   Upon the approval of the Mentored Ministry Learning Covenant, students will receive a course number for the particular rotation. Using this course number, student must complete the registration form and submit it to the Coordinator of Mentored Ministry. This form must be submitted in order for any rotation to be properly registered.
Mentor Nomination Form   This form should be completed by the proposed mentor and submitted to the Coordinator of Mentored Ministry when the student wishes to nominate a prospective mentor. Upon receipt, the Coordinator will review the form and initiate an appointment to discuss the program with the student and mentor.
Mentored Ministry Covenant   This form summarizes and formalizes the basic agreement and expectations between students and mentors. It should be submitted after the initial appointment with the Coordinator of Mentored Ministry.
Mentored Ministry Progress Report   This formative evaluation report should be completed by the mentor and submitted to the Coordinator of Mentored Ministry twice annually at the end of the spring (May) and fall (December) semesters.
 
Supervisor Information Form   On occasion, someone else besides a chosen mentor will provide oversight and supervision for a particular rotation. This form should be completed by the rotation supervisor and submitted by the student with his or her rotation learning covenant to the Coordinator of Mentored Ministry.
Learning Covenant Cover Sheet   This form should be signed by both the student and mentor/supervisor and submitted with a completed Mentored Ministry Rotation Learning Covenant.

 
Learning Covenant Worksheet   This form provides a template to guide the student and mentor/supervisor in developing an educational plan for a specific rotation. The student should use this form to create a separate document that should be submitted to the Coordinator of Mentored Ministry before registering for a particular rotation. Upon receipt of this document, the Director will evaluate the learning plan and suggest any needed changes before approving the proposed rotation.
Evaluation Cover Sheet   Upon completion of a particular rotation, both student and mentor/supervisor must sign off on the finished work using this form. It should be submitted with the mentor/supervisor’s Evaluation of Rotation form (see below) and the Student’s Rotation Report (see below). A student will only receive credit for a rotation when all three forms are submitted.
Mentor Evaluation of Rotation   Upon the completion of a particular rotation, the mentor/supervisor should complete this form and schedule a time to discuss this evaluation with the student. After the final supervisory meeting, this form should be submitted to the Coordinator of Mentored Ministry.
Student Rotation Report Template   At the completion of a particular rotation, the student should complete a report along the guidelines indicated in this form. In addition to this report, any additional outcomes from the rotation such as written products, pictures, video, etc. can be submitted to the Coordinator of Mentored Ministry to be included in the student’s Mentored Ministry file. A student will only receive credit for a completed rotation when the mentor’s Evaluation of Rotation form, the student report, and the Evaluation Cover Sheet are submitted.