Volunteer Application

Volunteer Application
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email
example@example.com
Date of Birth*

MonthDayYear
Date
Marital Status

SingleMarriedWidowed
Interests*

Class MealsOffice: Newsletter, Paperwork, etc.Fundraisers: Banquet, Baby Bottle Drive, Diaper DrivesSpecial Projects: Ministry Home, Baby Showers, Repairs, etc.Thrift Store: Sorting, Donation Pick-up, etc.Client TransportationClient MentoringInternshipsCleaningOther
Type of Volunteer*

Volunteering With a GroupOne-Time Individual VolunteerRe-occurring Individual VolunteerSchool Volunteer Hours NeededCommunity Service Hours NeededOther
Volunteer Group (If Applicable)
Volunteer Agreement
Recognizing that Mercy Manor is an evangelical ministry, I openly acknowledge my personal faith in Jesus Christ as my Lord and Savior. As a Christian, I daily strive for a lifestyle that is holy and pleasing to the Lord. I have read the Mercy Manor Statement of Faith and am in complete agreement with all statements in it.

I believe in the sanctity of human life as taught in the Bible and, therefore, reject abortion as an acceptable option for a woman facing a crisis pregnancy. I will at no time participate in any action, which results in the destruction of innocent human life.

I accept responsibility to act as an advocate on behalf of the women under my care; to give them accurate information, emotional support, and spiritual guidance. All information on Mercy Manor clients/residents will be kept in the strictest confidence. I will continue to keep the information confidential even after I am no longer a volunteer for Mercy Manor.

Understanding the vital role volunteers play in the work of the ministry of Mercy Manor. I will also attend an initial orientation and any further volunteer meetings or training sessions provided that will help me fulfill my role and equip me for this service.
Do you agree to these terms?*

I Agree
Confidentiality Statement
Through your employment/volunteer activities and duties, you may learn of or have access to client information and reports. Such confidential information is sensitive and is protected by law and by strict policies of Mercy Manor. The intent of the laws and polices is to assure that confidential information remains confidential, and that it is used only to provide client services.

Your duties and obligations with regard to confidentiality are described below. It is important that you carry out these duties. Your inability to complete these obligations may require ending your involvement as a staff member or volunteer of Mercy Manor.

1. I will use confidential information only as needed to perform my duties as a staff member or volunteer of Mercy Manor. This means I will only access confidential information for which I have need; and I will not any way divulge, copy release, sell, loan, review, alter or destroy confidential information, except as properly authorized by Mercy Manor. I also will not misuse or act carelessly with confidential information.

2. I will safeguard and will not disclose information that could allow access of others to confidential information.

3. I will discuss activities by individual or entity that may compromise the confidentiality of client information with the Executive Director or appropriate Mercy Manor employee.

4. I understand that my obligations under this agreement will continue after my involvement as a staff member or volunteer of Mercy Manor ends.

5. I understand I have no right or ownership interest in any confidential information referred to in this agreement. I will safeguard and retain the confidentiality of all confidential information.

6. I will be responsible for my actions in handling confidential information and do so in a manner that is honoring God, others, and myself. I understand that my failure to comply with this agreement may create legal vulnerability for Mercy Manor and myself.
Do you agree to the Confidentiality Statement?*

I agree
Photo Consent
I grant permission to Mercy Manor, to take and use: photographs and/or digital images of myself for use in personal records, printed publications or materials, electronic publications, or websites. I understand that my name may be revealed in descriptive text or commentary in connection with the image(s). I authorize the use of these images without compensation to me. All negatives, prints, digital reproductions shall be the property of Mercy Manor.
Photo Permissions*

I grant permission to Mercy Manor.I would prefer not to have my picture taken.

Volunteer Application

Volunteer Agreement

Confidentiality Statement

Photo Consent

Volunteer Orientation *Required*

Volunteer Orientation Required