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Love - Challenge - Equip

VOLUNTEER APPLICATION

(mm/dd/yyyy)  
 
(xxx-xxx-xxxx)
(xxx-xxx-xxxx)

VOLUNTEER HISTORY / AREAS OF INTEREST

What other ministries/non-profit organizations have you been involved with, for how long, and what was your role?
Which volunteer roles are you most interested in (please check all that apply)?











Other roles you are interested in (please give details below):
Do you have any other skills or professional resources that you would be willing to offer to Jeremiah’s Promise?

RELIGIOUS AFFILIATION

Do you attend Church? Yes No
Name of Church Are you a Member? Yes No
How often do you attend?




Special Occasions
Please describe any significant thoughts or feelings you have in regard to Christianity, including your understanding of what it means to be a Christian and any significant personal experiences that have shaped your beliefs and/or feelings about it.
Briefly describe your childhood, including any significant struggles you have faced. Also include any personal counseling or recovery process relating to your past that you have worked through as an adult.
Have you at any time been accused, rightly or wrongly, of child abuse, sexual molestation or neglect? If YES, please explain fully.
Have you ever been arrested for/convicted of anything more serious than a traffic violation? If YES, please explain fully.
Have you ever been treated for any nervous or mental illness? If YES, please explain fully.

PERSONAL REFERENCES

Name Phone Number Email
(xxx-xxx-xxxx)
Name Phone Number Email
(xxx-xxx-xxxx)
Name Phone Number Email
(xxx-xxx-xxxx)

BEFORE YOU SUBMIT...

I authorize the staff, administrators or representatives of Jeremiah’s Promise to verify the information on this form. Jeremiah’s Promise representatives may contact my references and appropriate government agencies as deemed necessary in order to verify my suitability for a volunteer role with Jeremiah’s Promise. I verify that the above information is completely true. Yes No

 

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