Volunteer Application Form

Volunteer Application
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail*
Home Number*

Area CodePhone Number
Cellular Number

Area CodePhone Number
Birthday*

MonthDayYear
Church (if applicable)
Occupation
How did you hear about Micah House?*
Why would you like to volunteer at Micah House?*
What languages do you speak?*
Please describe other volunteer experiences you've had:*
Please describe any cross cultural experiences you've had:
What are some of your interests, hobbies, and special skills?
How would you like to be involved at Micah House?*
How often would you like to volunteer?*

WeeklyMonthlyOccasional
Select your availability? *

DaytimeEveningWeekends
Please provide the names and phone numbers of two people we may contact as a reference e.g. teacher, previous employer, pastor.
Name*
Phone number*
Relationship*
Name*
Phone number*
Relationship*
I understand that I will be required to submit a Vulnerable Sector Police Check*

Yes
Signature*
Type name
Signature date*

MonthDayYear
Should be Empty: