Volunteer Application Form

Volunteer Application
Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
E-mail *
Home Number *

Area Code Phone Number
Cellular Number

Area Code Phone Number
Birthday *

Month Day Year
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? *

Weekly Monthly Occasional
Select your availability? *

Daytime Evening Weekends
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 *

Month Day Year
Should be Empty: