Grace Centers of Hope

Name (required):

Birthdate:

Address (required):

E-mail (required):

May we contact your regarding opportunities at GCH via email?
Yes No

Telephone (required)
Alternate Telephone

Male Female

Education Status: (Select from the category that most closely applies)

Middle/High School Student:

School Name:

City, State:

College/University:

Degree Obtained:

In Case of Emergency Contact: (Name)

Relationship:

Telephone:

Current Employment: (Employer)

Position

City, State:

Telephone: How Long?

Please list any skills or talents or hobbies that you feel could be utilized at GCH

BACKGROUND CHECK INFORMATION

Have you ever been convicted of any offenses by a civilian or military court?
Yes No

Have you been or are you now being charged with any criminal offense, or are there any civil courts actions or judgments now pending against you?
Yes No

If you answered “yes” to either of the above questions, please provide details. State the date and place of each arrest, court action or judgment. Give the nature of the charge or court actions, and current status of disposition including any sentence or fine imposed. Provide a complete explanation of the circumstances.

Availability (Please check days and times you are available to volunteer)

Days: Monday Tuesday Wednesday Thursday Friday Saturday Sunday

Times: Morning Afternoon Evening

Area of Interest (Please check all volunteer areas in which you are interested)

Women’s Program
Men’s Program
Kitchen
Maintenance
Electrician

Plumber
Carpenter
Child Care
Christmas
Golf Outing

Fundraising
Office Help
Data Entry
Music
Learning Center

Rescued Homes
Rescued Treasures
Counseling
Computer Technology
Other

Is your visit affiliated with a church, business, educational or civic organization?
Yes No

Name of Organization

Contact Name:

If yes please fill out the organizational information completely.

Address:

Phone:

How did you learn about volunteer opportunities at Grace Centers of Hope?
(Check all that apply)

Radio
TV
Internet
Newspaper

Men of Grace Concert
Civic/Service Group
Friend

Teacher/Counselor
Church
Walk-in

Other

Thank you for your volunteer application and your willingness to partner with
Grace Centers of Hope fulfill our goal of…
Saving A Life… Saving The Family… Saving Our Nation.
We look forward to working with you.

All information provided is true and accurate to the best of my knowledge

I accept and agree to the above terms of acceptance.

Grace Centers of Hope does not share or sell personal information with other organizations.