Pre-Employment & Volunteer Screening
for both employment and volunteer opportunities.
Full Name
First Name
Middle Name
Last Name
DOB
Sex
Please Select
Male
Female
Marital Status
Please Select
Single
Married
Divorced
Separated
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
E-mail
example@example.com
Emergency Contact / Relation / Contact Phone Number
Name
Relation
Phone Number
Questions and Details
Have you ever been convicted of a felony?
*
yes
no
If yes, please explain:
Highest level of education:
*
Current or Most Recent Occupation
*
Do you consider yourself a Christian?
*
yes
no
Church Name/Address if applicable:
List any special training, Biblical studies, or other educational experiences. Also, describe any positions you have held, or services performed within the church.
*
Pregnancy Center West has volunteer opportunities in several different areas. Please check those which you feel are most compatible with your talents and interests if you are seeking volunteer opportunities
Client Advocate: meeting with women in possible crisis pregnancies.
Administrative: helping with mailings, and other misc office duties as needed.
Resources
Event/Fundraising
Briefly state why you are interested in employment and/or volunteer opportunities at PCW:
*
What special talents, gifts, or personality strengths do you bring to this ministry?
*
Under what circumstances would you consider abortion to be a suitable choice?
*
Never an option
In cases of incest or rape
In cases of extreme psychological stress
If a doctor advised abortion because of health of mother
If the mother's life is possibly at risk
What is your position regarding abortion>
*
Do you have any personal stories related to abortion or adoption? If so, how would you feel about sharing with a client? (Sharing personal stories is never required of volunteers.)
Have you ever counseled a woman who was considering abortion or adoption, or was facing a crisis pregnancy? If yes, please explain.
*
How would you rate your knowledge of abortion?
*
Good
Fair
Poor
How would you rate your knowledge of abortion laws?
*
Good
Fair
Poor
How would you rate your knowledge of Biblical teaching regarding abortion?
*
Good
Fair
Poor
How would you rate your knowledge of pregnancy and prenatal development?
*
Good
Fair
Poor
Under what circumstances would you consider sexual intercourse to be appropriate?
*
Within a marriage between a man and woman
If they are considering marriage
If they are living together
Other
What is your position regarding the use of birth control or contraceptives (married or unmarried)?
*
How would you rate your knowledge of various birth control methods or contraceptives?
*
Very well informed
Fairly well informed
Not well informed
Are you familiar with methods of Natural Family Planning (NFP)?
*
yes
no
Please select the NFP methods which you know.
*
Rhythm
Ovulation Method
Temperature
Sympto-Thermal
None of the Above
Do you know the difference between abstinence and chastity?
*
Would you feel comfortable discussing abstinence and chastity with a client?
*
Date
-
Month
-
Day
Year
Date
Please verify that you are human
*
Submit
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