PRC Volunteer Form

PRC Volunteer Form
Personal Information
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Gender*
Marital Status*
Please describe your living arrangements. *
Do you have children?*
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email Address*
example@example.com
Driver License Number*

Address
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Emergency Contact
Emergency Contact Name*

First NameLast Name
Emergency Contact Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.

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?*

Education
High School Graduate?*
GED?*
If you went to college, describe when and where you attended.
Describe any training or degrees you have.

Previous Volunteer Experience
Name of Organization*
From*

MonthDayYear
Date
To*

MonthDayYear
Date
Organization Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
What were the responsibilities/duties of your position?
Supervisors Name

First NameLast Name
Supervisors Phone Number
Please enter a valid phone number.Format: (000) 000-0000.

Employment History
Employer*
Employed From*

MonthDayYear
Date
To*

MonthDayYear
Date
Employer Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
What were the responsibilities/duties of your position?
Supervisors Name

First NameLast Name
Supervisors Phone Number
Please enter a valid phone number.Format: (000) 000-0000.

Church Involvement
Name of Church*
Denomination*
Church Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Pastor's Name *

First NameLast Name
Pastor's Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Which ministry position did you serve?*
Will you be able to provide a current or previous ministry reference?*
Do you have 2-5 people that can provide ongoing prayer support?*

Background Information
Have you ever been convicted of a crime?*
Please explain*

Significant Losses
Have you personally experienced a loss in any of the following?*

AbortionMiscarriageLoss of child or loved oneNone of the above
Please explain*
Have you received counsel for the situation listed above?*
Have you walked through one or more of the above with a friend/ family member?*

Unintended Pregnancy Experience
Have you ever consulted with a woman or man who was considering an abortion? *
Please explain.*
Have you had traumatic experiences related to abortion?*
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.*

Christian Faith & Beliefs
Do you consider yourself a follower of Jesus Christ? *
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?*

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)*

Acknowledgment
I understand that an inquiry may be made which will provide information concerning my character, reputation, and Christian maturity*

Yes
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