Volunteer Application Confidential This application is to be completed by all applicants for any volunteer position at Exodus Ministries. This is not an employment application form. Your Name Email Daytime Phone Evening Phone Street Address City State Zip Gender malefemale Marital Status marriedsingleengageddivorcedwidowed Number of Children Name and Age of Children Church Affiliation Previous Churches List the names and addresses of other ministries and/or churches you have attended regularly during the past five years and any experience working with adults/children/youth (if applicable) Employer Occupation Please mark areas of interest. Select all that apply. Areas of Interest Adult Bible Study TeacherApartment Make-ReadyBirthday PartiesChildcareChildren's Bible Study TeacherChildren's Mentor/TutorCreative SkillsJob Coaching Areas of Interest MaintenanceMentoringOrganizing the Donations ClosetPhotographyPlanning/Sponsoring Family OutingsProfessional Skills TeacherReference CallsOther Prior Volunteer Experience Volunteer Experience Contacts Contact person(s) for previous volunteer work (Name and Phone Number) Skills List any gifts, callings, training, education, or other factors that have prepared you to work with adults, children, or youth. Education Level Highest Level of Education Attained high schoolsome collegeundergraduategraduatepost-graduate Handicaps Do you have any physical handicaps or conditions preventing you from performing certain types of activities related to children's work? (If yes, please explain below.) YesNo Handicaps Explanation Explanation (optional) Why Involved Why do you want to be involved in children/adult ministry? (i.e. school credit) Why Involved When and how often are you able to volunteer? Personal References Please provide personal references (cannot be former employers or relatives) Reference #1 Name Address Email Telephone Reference #2 Name Address Email Telephone Reference #3 Name Address Email Telephone Pastoral Reference Pastor, Associate Pastor, or Ministerial Supervisor Pastor Name Address Email Telephone Family Reference Family Member Name Address Email Telephone Important Information If approved, it will be your responsibility to report any suspected abusive behavior to the Executive Director of Exodus Ministries, or to the most senior staff member available, as soon as possible, but in no event more than 24 hours after learning of such incident. All outside group activities must be approved by the Executive Director You will be subject to a criminal background check before being approved as a volunteer with Exodus Ministries. Once we receive your application, we will contact you with appropriate release forms. You will be asked to provide your social security number and a copy of your drivers license.