Volunteer Application

Fill out the North End Community Ministry volunteer application below.

 

Full Name: Middle Initial:
Maiden Name: Other Name Used:

Address:
City:        
State:      
Zip:          

Phone Number:
E-Mail Address:
Date of Birth:    
Ethnic Background:
WhiteBlackHispanicAsian/Pacific IslanderAmerican Indian/Alaskan NativeUnknown/Other
Emergency Contact Name:
Emergency Contact Number:
Relationship Status: MarriedSingle
If married spouse's name

Skills and/or Experience:

Why do you want to Volunteer at NECM:


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I release North End Community Ministry from any and all liability with respect to the investigation, verification and/or use of any information relevant to my application for a staff or volunteer position. I certify that the information contained on this form is true, correct and complete to the best of my knowledge and I understand that any misrepresentation, falsification, or omission of facts on my application materials may be grounds for disqualification or termination.

*This information is used to obtain relevant data as required to perform a background check. All information will be held confidential and will only be used for this purpose.

By typing your name in the box below you agree that this constitutes a signature needed for us to proceed with a background check

 

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