Keturah's Haven

Keturah's Haven - Volunteer Application

Please Fill Out the Volunteer Application and We Will Reach Out to Schedule an in Person Interview
Acknowledgement of Confidentiality – Volunteer Keturah’s Haven

As a board member, volunteer or staff member of Keturah’s Haven, I hold in high esteem the privacy of our participants. Any information shared by them or by the staff will be kept in confidence. I will guard against any conversation that would violate confidentiality by being very discrete about what I discuss both within and outside the ministry.

I will share with the staff any sensitive information for the welfare of Keturah’s Haven and the men involved. I understand that if a participant at Keturah’s Haven has a grievance, it should be taken to the Executive Director. I am aware that certain information pertaining to internal matters should be kept confidential.

I have been informed of the policy of confidentiality, and my signature below indicates my understanding and acceptance.
Signature*

First NameLast Name
Today's Date *

MonthDayYear
Date
I declare that I have no criminal, social or medical history that would adversely affect my capacity to work with the participants of Keturah’s Haven.
Signature*

First NameLast Name
Today's Date*

MonthDayYear
Date
Personal Information:
Full Name:*

First NameLast Name
Email Address*
example@example.com
Date of Birth:*

MonthDayYear
Date
Driver License Number:*
Home Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number:*
Please enter a valid phone number.
Marital Status:*
Children's Names and Ages:
Education:

Select Last Year Completed
High School*
College:*
Please list Your Major and Any Degrees Obtained
Health Record
Condition of Health *
Physical Limitations*
Describe Any Serious Illnesses You have Had*
Current Employment Information
Company Name
Address/City/State/Zip
Immediate Supervisor
Christian Commitment
Are You a Christian?*
If you were to die and stand before God at the gates of heaven and were asked why you should be allowed to enter, what would you say?*
Describe You Devotional Time:*
Are You Comfortable Sharing Your Faith With Others?*
What is the Name and Address of the Church You Attend?*
May We Call Your Pastor? If Yes, Please Include Name and Number.*
List Positions Held or Services Performed in Church.*
General Information
Describe Your Personality:*
What Kind of Person Do You Work Well With?*
What Kind of Person Easily Irritates You?*
Have You Had Experience Dealing With Someone In Crisis? (Explain)*
Have You Ever Known an Unwed Parent?*
How Do You Feel About Adoption as an Alternative for a Woman in a Crisis Pregnancy?*
What are Your Feelings About Abortion?*
How Do You Feel About Unwed Parent(s) Raising Their Children?*
Do You Have Any Predjudice in Dealing With Minorities?*
Please List Two Personal References We May Contact Other Than Your Pastor or Relatives That We May Contact (Included Name and Phone Number):*
Personal Interests
What Are Your Present Hobbies?*
What Special Interests Do You Have?*
Involvment
I am Interested in my Class/Small Group Becoming Involved With Keturah's Haven.*
Please List The Areas You Are Interested in Volunteering (Mentoring, tutoring for GED, Cooking, Fundraising & Events, Prayer Warriors, Assitance in the Home):*
What does Mentorship look like to you?
Are you willing to serve in all areas?
What are your strengths or giftings?
What drives you to get connected?
What do you do in your free time?
When Would You Be Available to Volunteer?*
What Days and Times Are You Available to Volunteer?*
Is there anything else you would like to share? Or anything else we need to know?
Autorization

Staff and Volunteers
I understand that an inquiry may be made which will provide information concerning my personal ethics, general reputation, and Christian character. I am willing to abide by all the rules established by Keturah’s Haven and realize that if I become part of the ministry staff or volunteer, I am part of a team and will support the decisions made by the Board of Directors.

All staff and volunteers are to complete a full background check.
Name*

First NameLast Name
Today's Date*

MonthDayYear
Date
Should be Empty:

Keturah's Haven - Volunteer Application

Personal Information:

Education:

Health Record

Current Employment Information

Christian Commitment

General Information

Personal Interests

Involvment

Autorization