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Hope Volunteer Application Form
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Name *
Date *
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Address *
City *
State *
Zip code *
Phone number *
Email *
Date of birth *
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Have you ever been convicted of a crime? *
If yes, please explain.
Education completed: *
Area of study: *
Other training:
What is your reason for seeking to volunteer with Hope? *
Are you a Christian? *
What is the basis of your salvation? *
What is your church's name and denomination? *
What is your church's address? *
Which positions have you served in at your church? *
This organization is a Christian pro-life ministry. We believe our faith in Jesus Christ empowers us, enables us, and motivates us to provide life-giving services in this community. Please write a brief statement about how your faith would affect your volunteer work at this center. *
What special skills, talents, gifts, or personality traits would you bring to this ministry? *
Have you ever counseled a woman who was considering an abortion? *
Please explain.
Have you had any experiences relating to abortion (personal, family, friends, other)? *
Have you personally had an abortion? *
Have you ever been a victim of abuse (physical, emotional, or sexual)? *
Please explain.
Please include three references, including a pastoral reference, a professional reference, and a personal reference.
Reference 1 - please include name, email, phone, years acquainted and relationship. *
Reference 2 - please include name, email, phone, years acquainted and relationship. *
Reference 3 - please include name, email, phone, years acquainted and relationship. *
What is your availability? Split shifts are available. *
Required
Areas of interest for volunteering: *
Required
Please list an emergency contact, including name, relationship and phone. *
Applicant's certification and agreement

I certify that the facts set forth in this volunteer application are true and complete to the best of my knowledge, and I authorize HOPE IN NORTHERN VIRGINIA to verify their accuracy and to obtain reference information concerning my character and capabilities. I release HOPE IN NORTHERN VIRGINIA and any person or entity providing such reference information from any and all liability relating to the provision of such information or relating to any decisions made based upon such information. I give permission to the center to conduct a criminal background check to the extent that my volunteer duties may involve direct interaction with minors. If I become a volunteer HOPE IN NORTHERN VIRGINIA, I agree to fully adhere to its policies and rules, including those rules relating to maintaining client confidentiality. I understand that a volunteer will serve in a different capacity than the employees of HOPE IN NORTHERN VIRGINIA, and that a volunteer position will not receive compensation in return for any volunteer services.

I further certify that I have read and am in full agreement with the HOPE IN NORTHERN VIRGINIA statement of faith and code of conduct.
Applicant signature. (Please write your name.) *
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