Matrix LifeCare Volunteer Application
Hello! Thank you for your interest in volunteering with Matrix LifeCare Center. We are appreciative of your time and thank you in advance for filling out your application.

Who we are:
At Matrix LifeCare Center we believe that all people, from conception to natural death, are made in the image and likeness of God, making each life a priceless gift that deserves to be protected and loved. We are a non-profit organization dedicated to promoting the dignity of every human life and to empowering the Lafayette community to do the same by providing support, education, and resources to women and families in need.

Matrix LifeCare Center exists to provide education, support, and resources that empower individuals to make life-affirming decisions before, during, and after pregnancy. *
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First Name *
Your answer
Last Name *
Your answer
Email *
Your answer
Address *
Your answer
Phone number *
Your answer
Date of Birth *
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Employer/Job title
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Do you have any special licenses, certifications or medical credentials? Please list. *
Your answer
Do you speak any languages other than English? If so, please specify which languages. *
Your answer
Please post which hours you are available within our regular office hours- Regular office hours are: Mon 9-5, Tues 12-7, Wed 9-5, Thurs 9-5 and Fri 9-3. *
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How did you hear about Matrix LifeCare Center? *
Your answer
Please select the area you are interested in volunteering: *
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Have you ever volunteered at Matrix LifeCare Center or any other Pregnancy Resource Center before? What was your volunteer role there? *
Your answer
Do you consider yourself pro-life or pro-choice? What does this mean to you? *
Your answer
Do you have a criminal background? If yes, please explain. *
Your answer
Have your ever had a Child Protective Services case? If yes, please explain. *
Your answer
References: please list 3 references, their relationship to you, and their phone number. *
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By submitting this form, I attest that I have read and agree to the following:
I understand and agree that submitting this application form does not automatically register me as a Matrix LifeCare Center volunteer, and that there may be certain qualifications I must meet, including the acceptance of established policies and procedures before I may begin volunteering.
By submitting this form, I attest that the information I have provided on the form is true and accurate.

Your next step is to attend a volunteer call-out where we will provide you with more information about our Mission and about what being a volunteer in each role involves.The call-outs will be held at our Main Office at 938 Mezzanine Dr. Ste, B, Lafayette, IN 47905. Please select ONE of the following call-out dates that you will attend. Call 765-742-1533 if you have any questions. *
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