Street Address Line 2
State / Province
Postal / Zip Code
Date of Birth
Emergency Contact Information:
Relationship to you:
Phone Number of Emergency Contact:
Email of Emergency Contact:
Why do you want to volunteer with Safe Haven Bridging Gaps?
Availability to Serve
What do you hope to be able to contribute to Safe Haven Bridging Gaps Company?
Have you volunteered with other organizations before? If so, which ones?
What is your favorite thing about volunteering?
Have you ever had a negative experience with volunteering with other organizations? If so, PLEASE DO NOT TELL ME WHICH ORGANIZATION but describe the experience.
Name of School:
List any education, work training and/or ministry experiences that might be helpful for us to know. Please be specific (Bible school training, trade school, job skills, internships, talents, interests, hobbies, etc.)
What do you see as your strongest character quality? Why?
What do you see as your weakest character quality? Why?
Is there anything else you feel would be helpful for us to know?
Are you currently under a physicians care for any medical/mental illness? If yes, please explain.
Do you take any medications? If yes, please explain.
Do you have any physical handicaps or conditions that would prevent you from performing certain types of activities? If yes, please explain.
Do you have any food restrictions? If yes, please explain.
Relationship to You
Number of years/months they have known you:
Should be Empty:
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