Site Name Address Street City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Zipcode Website Primary Supervisor Title First Name Last Name Supervisor Position Supervisor e-mail * Your e-mail (if different from supervisor e-mail) Site Profile Type of site - None -AgencyEducationHealthParishOther Denominational Affiliation, if any Site Description Please list some of the salient characteristics of your congregation or constituents, e.g., mission objectives, significant history, organization/parish demographics, cultural or environmental context, regularly scheduled events. Opportunities for student involvement Supervisor Profile Year began this type of ministry or work Ordained No Yes Year Ordained Year began current position If this is not your first position in this field, please indicate the related positions held in the last ten years (title, location, and dates) Previous supervision experience and training What interests you about mentoring a YDS student? Additional Supervision If others will be instructing and supervising the intern, please explain below, including how supervision will be shared Commuting/Transportation Information for Student Additional information (e.g., housing arrangements, requirements like TB test or background check, schedule expectations, presence of other interns) Please attach a resume for each supervisor 3. Supervisor Resume Files must be less than 2 MB.Allowed file types: txt rtf pdf doc docx ppt xls. Supervisor and Site Agreement I agree to the following: 1. As the person who will direct and observe most of the student’s work, I will serve as the student’s primary supervisor. 2. To the best of my knowledge, I will be available to supervise for the entire internship, planning no absence greater than one week without prior approval from the Director of Supervised Ministries. 3. I have had a minimum of three years’ experience in my vocational field and at least one year in my current position. I am employed full time in a long-term position rather than as an interim. 4. I will spend at least one hour a week meeting individually with the student. 5. I will conduct myself professionally and ethically, including refraining from any speech or action that is sexual in nature, and I will ensure a non-hostile learning environment for the student intern. I have never been sanctioned for professional misconduct, and there are no charges currently pending against me. 6. I will abide by all policies and procedures set forth by the Yale University Divinity School Office of Supervised Ministries in relation to the internship. 7. I will participate in the New Supervisor’s Orientation prior to the start of the internship (if a first-time YDS supervisor) and, occasionally, continuing education events for supervisors, at the request of the Director of Supervised Ministries. Yale University Hold Harmless Agreement The site listed above agrees to provide internship placement opportunities for students in the supervised ministry program of Yale Divinity School. We further agree to indemnify and hold harmless Yale University and its current and former employees, officers, fellows, and agent from and against any and all damage, liability, injury, expense or loss relating to any third party claim which arise or result from the negligent acts or omissions of any employee, volunteer or agent of this site. Clicking SUBMIT online below indicates your agreement to all of the above conditions and affirms the truth of the information you have provided.