CORM Volunteer Application
Please read carefully and answer the following questions honestly. Your answers to these questions will not necessarily disqualify you for acceptance. The information you share with us will be treated as confidential.

***If you are interested in volunteering with City of Refuge Ministries for any reason please be sure you have received your letter of invitation prior to purchasing your airline tickets.***
Email address *
Full Name ( as it appears on your passport) *
Sex *
Mailing Address *
City *
Zip Code *
State *
Phone Number
Email Address *
Date of Birth *
MM
/
DD
/
YYYY
Marital Status *
Passport Number *
Proposed Dates of Trip *
Confidential Information
Have you ever had a conduct hearing or disciplinary measures taken regarding your behavior on a school campus? *
If yes please explain
Have you ever been convicted of a felony? *
If yes please explain
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