Volunteer Application

Full Name
Email Address
Street Address
City
State
Zip
Telephone
Date of Birth
(ex: mm/dd/yyyy)
Do You Have a Valid Drivers License
Do You Have Valid Auto Insurance
In the Event of an Emergency, Please Notify
Name:
Relationship:
Phone:
Address:
Education
High School:
Years Attended:
College(s):
Years Attended:
Major:
List Your Work and Volunteer Experiences
Employer or OrganizationDatesPosition/Responsibilities
Were Any of the Above Experiences with Children (explain)
List Your Skills
List Your Hobbies/Interests
Evaluate Yourself

1 = Almost Never 2 = Seldom 3 = Sometimes 4 = Often 5 = Almost Always

Social12345
Friendly
Willing to Forgive/Apologize
Discreet to Opposite Sex
Perceptive
Emotional12345
Stable
Patient
Even-tempered
Spiritual12345
Faithful in Christian Work
Consistent
Strong Personal Witness
Personal12345
Confident
Self-motivated
Creative
Ability to Follow Guidelines
Enthusiastic
Careful in speech
Flexible
Dependable
Common sense and judgement
Critical
Domineering
Irritable
Intolerant
Argumentative
Cooperative
Please add any additional comments regarding the above self-evaluation
Affiliation with what church?
When are you available?
Have you at any time ever:
Been convicted of, or pleaded no contest to, any felony? Yes No
Engaged in any child molestation, exploitation, or abuse? Yes No
If the answer to either of these questions is, "yes," please explain in detail:
Give the reference check forms to two people who know you well and can provide a character reference for you. These could include a work supervisor, teacher/professor, church leader, relative (outside immediate family), or friend. The forms should be sent back to the Volunteer Coordinator by the references.