EmailMe Form - Volunteer Opportunities Application

First Choice

Second Choice

Third Choice

Fourth Choice

I believe I could serve in these capacities because of the following experience

My Abilities

My physical activity is limited

Yes

No

If yes in what way

Abilities Reference

As a reference to my abilities, I have worked as a volunteer at the following:

Facility

Phone

### - ### - ####

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country

Contact Person

First Last

Email

Church Membership

Complete Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country

Name of Pastor

First Last

Phone

### - ### - ####

Email

Housing

I understand that, as a volunteer, my housing may be provided, but there will be no other remuneration or contribution toward my expenses.

I have an RV and neeed a site

Yes

No

I have my own campsite

Yes

No

I need housing

Yes

No (all housing is outlying so you need transportation

Personal Information

Tell us about you.

Your Name

First Last

Home Phone

### - ### - ####

Mobile Phone

### - ### - ####

Permanent Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country

Email

Dates Available

When can you be here?

From

MM / DD / YYYY

To

MM / DD / YYYY