Application for Voluntary Service

Education

Please list in order
Secondary School Name *
Degree or Diploma*
College Name
Degree or Diploma
Other Education
Degree or Diploma

References

Please provide three references
Reference #1:
1. Name*

First NameLast Name
a. Phone Number*

Area CodePhone Number
b. Years Known*
How do you know this person?*
i.e. He/She was my boss for 25 years at Petco
Reference #2:
Name*

First NameLast Name
A. Phone Number*

Area CodePhone Number
B. Years Known*
How do you know this person?*
i.e. He/She was my boss for 25 years at Petco
Reference #3:
3. Name

First NameLast Name
A. Phone Number

Area CodePhone Number
B. Years Known
How do you know this person?
i.e. He/She was my boss for 25 years at Petco
Please upload your cover letter and resume here

Upload a File

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Applicant’s Statement

I certify that the answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application form.

In the event of being accepted as a volunteer, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of Paxton Ministries.

The volunteer applicant understands that their signature authorizes Paxton Ministries to immediately initiate a “Criminal Background Check” as required by the State of Pennsylvania, Dept. of Welfare, Personal Care Division. Final volunteer approval is contingent upon approval by the Pennsylvania State Police and/or the Federal Bureau of Investigation.
Name*
Signature*

Clear
Draw with cursor
Date Signed*

MonthDayYear
Should be Empty:

	Very Interested	Interested	Neutral	Uninterested
Reception
Social Services
Maintenance
Housekeeping
Food Service
Activities

Application for Voluntary Service

Eligibility

Christian Life

Education

Employment Experience

References