Volunteer Application Form

Name *

First Name Last Name

Address *

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