Reflection Ministries Volunteer Application

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Volunteer Questionnaire

Email *

First and Last Name *

Phone Number

Date of Birth *

YYYY

What is your gender? *

Female

Male

Other:

Are you multi-lingual? *

Yes

If yes, please list other languages you speak fluently.

Address *

Highest Education Level

High School/GED

Some College

Current College Student

College Degree

Clear selection

If you have completed college, please give your year of graduation and field of study.

Current or Most Recent Employer *

Dates of Employment and Position(s) Held *

Are you the subject of a criminal investigation? *

Yes

Do you have any criminal charges pending? *

Yes

Have you ever been convicted of any criminal offense involving a juvenile/child or the direct endangerment of a juvenile/charge? *

Yes

Have you ever been convicted as a sex offender? *

Yes

Have you ever been convicted of a capital offense? *

Yes

Do you agree to notify Reflection Ministries within 24 hours if ANY of the above criminal history changes? *

Yes

Why are you interested in volunteering with Reflection Ministries? *

What is your monthly time commitment? *

1-5 hours monthly

5-10 hours monthly

10 or more hours monthly

What is your availability? *

Mornings

Afternoons

Weekends

Other:

Required

Do you have any special skills, interests, or qualifications that would be relevant to volunteering with us? *

Reference #1: First & Last Name *

Reference #1: Phone Number
*

Reference #1: Email Address
*

Reference #1: Place of Employment *

Reference #2: First & Last Name
*

Reference #2: Phone Number *

Reference #2: Email Address *

Reference #2: Place of Employment *

By placing my name below and submitting this application, I affirm that the facts herein are true and complete. I understand that if I am accepted as a Reflection Ministries volunteer any false statements, omissions, or other misrepresentations made on this application or references may result in immediate dismissal. I understand that Reflection Ministries is not obligated to provide a reason for their decision in accepting or rejecting me as a volunteer.

(please type full first and last name below)

Today's Date *

YYYY

Send me a copy of my responses.

Submit

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