The Potter's Place Volunteer Application

The Potter's Place Volunteer Application

Please complete the volunteer application form. Preserve the original wording and field order as much as possible.
Applicant Information
Full Name

First NameMiddle NameLast Name
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Phone
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Home Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
City / State / Zip
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Emergency Contact and Church Information
Emergency Contact Name

First NameMiddle NameLast Name
Emergency Contact Phone
Please enter a valid phone number.Format: (000) 000-0000.
Church you currently attend
Pastor / Church Contact
Volunteer Background and References
Other places you currently volunteer
Reference 1 Name

First NameMiddle NameLast Name
Reference 1 email/phone
Reference 2 Name

First NameMiddle NameLast Name
Reference 2 email/phone
Reference 3 Name

First NameMiddle NameLast Name
Reference 3 email/phone
Faith and Service Questions
Are you a Christian, with a personal relationship with Jesus Christ?
Are you comfortable praying with and for guests who ask for prayer?
Briefly share your faith journey or testimony
Areas of Interest

Other
If Other (Area of Interest), please specify
Availability (days/times)
Are you able to volunteer weekly?
Signature
Signature
Date (Signature)

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty: