Name
*
First Name
Last Name
Gender
*
Please Select
Male
Female
Date of Birth
*
-
Month
-
Day
Year
Date
Email
*
example@example.com
Phone Number
*
Address
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
What hours are best to contact you?
*
What line of ministry are you interested in?
*
Teen Ministry
Young Adult Ministry
Prison Ministry
Prayer Team
Fundraising crew
Teaching a Parent Class
GRIT small group leader
Do you have any experience with Regeneration Recovery Program? If so explain:
Do you have experience with recovery?
*
yes
no
Have you ever gone through recovery before? Please explain.
Have you done prison ministry before?
*
yes
no
if you have done prison ministry, what units have you had the blessing to go to, and through what organization?
Do you have experience with teens?
*
yes
no
If so, explain:
Why do you want to volunteer to make a difference in a teen/young adult's life?
Faith Background
We are a faith based non profit organization that wants to help teens/young adults/and incarcerated individuals grow their relationship with Jesus. Please answer the following questions about your faith background:
Tell us about how you came to know Jesus:
*
Name of Church You Attend
*
Religious Affiliation
*
Do you serve at your church now?
*
Yes
No
If you serve, in what areas?
What is your favorite bible verse?
Do you have any connections in our community to help with the ministry's passion to help and equip teens and adults in our community?For example: ISD, Churches, other non-profits, MHMR, local agencies, etc.
Volunteer's Signature
Date Signed by Volunteer
-
Month
-
Day
Year
Date
Submit
Submit
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