Volunteer Application Form

Emergency Contact Information
Contact Name: *
Relationship:
Phone Number*

Area Code Phone Number
Do you have any health or physical limitations that could affect your volunteer assignment? *
(Yes or No)
If yes, please explain
Have you been convicted of a crime within the last ten years?*
(Yes or No)
If yes, please explain
Would you be willing to submit a background check?
(Yes or No)
References:
Reference 1 Name *

First Name Last Name
Reference 1 Phone*

Area Code Phone Number
Reference 1 Email
example@example.com
Relationship to Reference 1
Reference 2 Name

First Name Last Name
Reference 2 Phone

Area Code Phone Number
Reference 2 Email
example@example.com
Relationship to Reference 2
Reference 3 Name

First Name Last Name
Reference 3 Phone

Area Code Phone Number
Reference 3 Email
example@example.com
Relationship to Reference 3

I understand that this is an application for, and not a commitment or promise of volunteer opportunities.

I certify that I have, and will provide accurate information throughout the selection process, including on this application and in interviews with Stanly Community Christian Ministry. I understand that misrepresentations or ommisions may be cause for my immediate rejection as an applicant for a volunteer position with Stanly Community Christian Ministry or my termination as a volunteer.

I understand that Stanly Community Christian Ministry is a Christian organization that operates based on Christian principles. Whereas we do not discriminate against anyone for their religious beliefs, we do openly demonstrate our faith through our operating priniciples, ore values and actions.
Signature*
Date*
Please attach a photo of your driver's license.*

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Volunteer Application