EmailMe Form - Victory Ministries Volunteer Application-Section 1

Name *
Prefix First Last
Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Primary Phone *
### - ### - ####
Secondary Phone
### - ### - ####
Employer
Work Phone
### - ### - ####
Email Address *
I Drive:
Car
Pickup
Van
Other
Church Where I attend
Length Of Attendance
Name of Pastor
Pastor's Phone
### - ### - ####
Emergency Contact
Emergency Contact Phone
### - ### - ####
Personal Reference(not a relative)
Personal Reference Phone
### - ### - ####
Are there specific interests that you wish to pursue as a volunteer?
Please list any other volunteer experience you have.
What do you enjoy most in a volunteer experience?
What do you wish to avoid?
Please mark the days you are available to volunteer
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Literacy NOW Reading Buddies may choose between Tues, Wed, or Thurs.
Volunteer Application - Section 2
Please select the Program you are interested in
Food Pantry
Clothing Store
Free Medical Clinic
Literacy NOW Reading Buddies
Other
Are you volunteering as part of a group?
Please select the type of volunteer activity you are interested in
Client Registration
Clothing Room Attendant
Food Pantry (Bagging, Sorting and Distribution)
Food Pick-Ups (vehicle required)
Answering Phones
Secretarial/Office
Handy Man (bldg repairs/upkeep)
Delivery to Shut-Ins and Elderly
Social Work
Admin to Clinical Counselor
I would like to learn more about
Volunteer Application - Section 3
Background Reference - (to be completed by all persons wishing to volunteer at Victory Ministries, Inc.)

PLEASE NOTE: A background check will be performed prior to acceptance as a volunteer. To conduct the background check, your full name, social security number, date of birth, and email (if available) are required. The Volunteer Coordinator will provide you a background check authorization form to complete.
Have you ever been convicted of a felony or misdemeanor? If Yes, please complete the information below. *
Offense
Offense Location
Offense Explanation
Offense Date Time
MM / DD / YYYY
Have you ever been reported to a social service agency or children’s service agency? *
If Yes, explain below.
Explanation
STATEMENT OF FAITH:
Victory Ministries believes…

The Bible to be the infallible Word of God, that it is His holy and inspired Word, and that it is of supreme and final
authority.

In one God, eternally existing in three persons—Father, Son, and Holy Spirit.

Jesus Christ was conceived by the Holy Spirit, born of the Virgin Mary. He led a sinless life, took on Himself all our
sins, died and rose again, and is seated at the right hand of the Father as our mediator and advocate.

That all men everywhere are lost and face the judgment of God, and need to come to a saving knowledge of Jesus
Christ through His shed blood on the cross.

That Christ rose from the dead and His return is imminent.

In holy Christian living, and that we must have concern for the hurts and social needs of our fellowmen.

We must dedicate ourselves anew to the service of our Lord and to His authority over our lives.

The Great Commission was given by Christ instructing every believer to “Go into all the world and preach the Good
News to everyone, everywhere.
I AGREE WITH THE ABOVE STATMENT OF FAITH: *
I agree and represent that:
The information is correct to the best of my knowledge. I authorize any references, or any other
person or organization, whether or not identified in this documentation, to give you information
- including opinions - regarding my character and fitness for voluntary service. I further
understand that a criminal records check may be conducted on me, and I consent to any such
check. I understand that if I have given any false or inaccurate information on this
documentation that it may serve as to disqualify me from eligibility for volunteer service. I have
also read and agree with Victory Ministries Statement of Faith.

Volunteer Application - Section 2

Volunteer Application - Section 3