Volunteer Application Form

Volunteer Application
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail
Home Number

Area CodePhone Number
Cellular Number

Area CodePhone Number
Birthday

MonthDayYear
Church (if applicable)
Occupation
How did you hear about Micah House?
Why would you like to volunteer at Micah House?
What languages do you speak?
Please describe other volunteer experiences you've had:
Please describe any cross cultural experiences you've had:
What are some of your interests, hobbies, and special skills?
How would you like to be involved at Micah House?
How often would you like to volunteer?
Select your availability?
Please provide the names and phone numbers of two people we may contact as a reference e.g. teacher, previous employer, pastor.
Name
Phone number
Relationship
Name
Phone number
Relationship
I understand that I will be required to submit a Vulnerable Sector Police Check
Signature
Type name
Signature date

MonthDayYear
Should be Empty: