PRC Volunteer Form
Personal Information
Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Gender
*
Please Select
Male
Female
Marital Status
*
Please Select
Single
Married
Please describe your living arrangements.
*
Do you have children?
*
Please Select
Yes
No
Phone Number
*
Please enter a valid phone number.
Email Address
*
example@example.com
Driver License Number
*
Back
Next
Address
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Back
Next
Emergency Contact
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
Back
Next
Volunteer Interest
How did you find out about the Pregnancy Resource Center?
*
What is your reason for seeking to volunteer?
*
What volunteer position are you interested in?
*
What day/days work best for you to serve?
*
Back
Next
Education
High School Graduate?
*
Please Select
Yes
No
GED?
*
Please Select
Yes
No
If you went to college, describe when and where you attended.
Describe any training or degrees you have.
Back
Next
Previous Volunteer Experience
Name of Organization
*
From
*
-
Month
-
Day
Year
Date
To
*
-
Month
-
Day
Year
Date
Organization Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What were the responsibilities/duties of your position?
Supervisors Name
First Name
Last Name
Supervisors Phone Number
Please enter a valid phone number.
Back
Next
Employment History
Employer
*
Employed From
*
-
Month
-
Day
Year
Date
To
*
-
Month
-
Day
Year
Date
Employer Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What were the responsibilities/duties of your position?
Supervisors Name
First Name
Last Name
Supervisors Phone Number
Please enter a valid phone number.
Back
Next
Church Involvement
Name of Church
*
Denomination
*
Church Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Pastor's Name
*
First Name
Last Name
Pastor's Phone Number
*
Please enter a valid phone number.
Which ministry position did you serve?
*
Will you be able to provide a current or previous ministry reference?
*
Please Select
Yes
No
Do you have 2-5 people that can provide ongoing prayer support?
*
Please Select
Yes
No
Back
Next
Background Information
Have you ever been convicted of a crime?
*
Please Select
Yes
No
Please explain
*
Back
Next
Significant Losses
Have you personally experienced a loss in any of the following?
*
Abortion
Miscarriage
Loss of child or loved one
None of the above
Please explain
*
Have you received counsel for the situation listed above?
*
Please Select
Yes
No
Have you walked through one or more of the above with a friend/ family member?
*
Please Select
Yes
No
Back
Next
Unintended Pregnancy Experience
Have you ever consulted with a woman or man who was considering an abortion?
*
Please Select
Yes
No
Please explain.
*
Have you had traumatic experiences related to abortion?
*
Please Select
Yes
No
Please explain.
*
Under what circumstances would you consider abortion as an alternative for a woman with an unintended pregnancy?
*
When do you think sexual activity is morally permissible? Explain.
*
Back
Next
Christian Faith & Beliefs
Do you consider yourself a follower of Jesus Christ?
*
Please Select
Yes
No
Briefly explain how you came to a relationship with Jesus Christ.
*
As a Christian, what do you believe about salvation?
*
What special skills, talents, gifts, or personality traits would you bring to this ministry?
*
What do you consider to be your possible areas of weakness?
*
Are there any personality types with whom you have difficulty working?
*
Back
Next
References
Please list 3 persons who are not related to you and who you have known for at least 5 years.
Reference 1 (Name, Address, Phone #, Years Known, Relationship)
*
Reference 2 (Name, Address, Phone #, Years Known, Relationship)
*
Reference 3 (Name, Address, Phone #, Years Known, Relationship)
*
Back
Next
Acknowledgment
I understand that an inquiry may be made which will provide information concerning my character, reputation, and Christian maturity
*
Yes
Submit Form
Should be Empty: