Christ Community

Date         Name   

Home Address    

Phone Number        

E-mail Address  

Date of Birth JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember   01020304050607080910111213141516171819202122232425262728293031    (year)

Social Security Number  

Driver's License Number  

Do you speak any other languages?

Yes:                    No:

If yes, which language(s)?  

How long have you attended Christ Community Church?  

If you are volunteering as a mentor, please indicate days and times you are available to give one hour (or more) to mentor a child:

Monday            Tuesday            Wednesday             Thursday            Friday
AM:              AM:               AM:                    AM:                 AM:
PM:              PM:               PM:                    PM:                  PM:

Previous Volunteer Activities:

If you are volunteering as a mentor and have a prayer partner in mind, please give us his/her contact information below:

Name  

Phone Number  

VOLUNTEER PLEDGE

If I am assigned as a school volunteer, I accept the responsibility to serve in support of the educational program and supplement the work of the professional staff under its supervision.  I understand that it is important to be reliable, channel suggestions constructively, keep information confidential, and comply with school rules.

A very positive benefit when working with students is the relationship developed between the volunteer and the student.  We take seriously the relationships which are formed.  For this reason, we check references of our volunteers through the legal system. 

By submitting this form, I authorize Christ Community's Kids Hope USA Director to make such inquiries.  I also agree to the responsibilities listed above.

 I have read and agree to the Volunteer Pledge.