Application Date   Volunteer Position Sought

Name

Home Address City State Zip

Home Phone   Work or Cell Phone   Email Address

Highest Level of Education

Current Employer

Employer Address

Position / Title

Dates of Employment Start Date End Date

Would you like the Mission to inform your employer of your volunteer service? Yes No

Special training, skills, hobbies

Groups, clubs, organizational memberships

Please describe your prior volunteer experience (include organization names and dates of service)

Why do you want to volunteer or what do you want to gain from this volunteer experience?

Have you ever been convicted of a crime? (If yes, please explain the nature of the crime and the date of conviction and disposition). Conviction of a crime is not an automatic disqualification for volunteer work.

Do you have a driver's license?

Yes
No

Do you have car insurance?

Insured
Not Insured

Do you have a car available for transporting others?

Yes
No

Have you ever received, or do you currently receive, services from the mission?

Received Services in Past
Currently Receive Services
Never

References
Please list three (3) people who know you well and can attest to your character, skills and dependability. Include your current or last employer.

Name/Organization               Relationship to You                Phone                  Length of relationship
        

Please read the following carefully before submiting this application:
I understand this is an application for, and not a commitment or promise of, volunteer opportunity. I certify that I have and will provide, throughout the selection process, this application and in interviews with Mooresville / Lake Norman Christian Mission, information that is true, correct and complete to the best of my knowledge. I certify that I have and will answer all questions to the best of my ability and position. I understand the Mooresville / Lake Norman Christian Mission will verify all information contained on my application. I understand that misrepresentations or omission may cause for my immediate rejection as an applicant for a volunteer position with the Mooresville / Lake Norman Christian Mission or my termination as a volunteer.

I have reviewed the Volunteer Handbook and Guidelines and will comply with the expectations therein. Failure to follow those procedures or mistreatment of the Clients, staff or volunteers at the Mission will also result in dismissal from volunteer opportunities.

I understand that while volunteering, if my picture is taken, it may be used in conjunction with print and web materials produced by The Mooresville/Lake Norman Christian Mission.

By checking this box I certify that I have read and agreed to the above statement.