Volunteer Sign up Form

Volunteer Sign up Form

You will be contacted when we receive your application and have reviewed it.
Full Name*

First NameLast Name
E-mail*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone Number*
Mobile Number*
Please enter a valid phone number.
Date of Birth*
Drivers Licence*
WWCC or Blue Card Number - If none type 000*
Current Place of Employment
Are you over 18?*

YesNo
Church you attend?
Are you Spirit Filled?
Languages you speak*
Emergency Contact Name and Phone Number*
Is there anything we should know in an emergency?
Preferred Area to Volunteer:*

Child CareAdministrationDrivingMealsCleaningGardeningArtMusicShoppingFacilitating CoursesBudgetingGeneral VolunteeringBoard MemberDirectorTreasurerSecretaryLive in SupervisorOther
Days and times you are available*

MondayTuesdayWednesdayThursdayFridaySaturdaySunday
Time of Day you are available*

MorningsAfternoonsEvenings
Have you ever been convicted of a crime and or within the last 2 years have you been convicted of a misdemeanor which resulted in imprisonment/jail?

YesNo
PERSONAL REFERENCE

Personal References must be over the age of 18years of age and not relatives. You must have known them for at least 2 years minimum.
Full Name of Reference

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
(Office Use Only) Name of Supervisor who checked Reference
(Office Use only) Date Reference Checked

MonthDayYear
CONFIDENTIALITY AGREEMENT

By Submitting this application, I promise that I shall hold in confidence all information regarding callers and clients of Yahweh House.

I will not violate the confidential relationship between the programs, volunteers, staff and callers/clients.

I will not remove from the office any written clients records or copies.

I understand and agree that I am personally responsible and liable for any violation of the agreement.
Signature

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Date

MonthDayYear
Date
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Volunteer Sign up Form

PERSONAL REFERENCE