VOLUNTEER APPLICATION Untitled Mr. Mrs. Rev. Name Cell PhoneHome PhoneResidence Address Street Address City State / Province ZIP / Postal Code Mailing address Same as residence New Mailing Address Street Address City State / Province ZIP / Postal Code Email Date of birth MM slash DD slash YYYY Race Gender Are you a California resident? Yes No Marital Status: Married Separated Divorced Single Emergency contactName PhoneEmployerName Address Street Address City State / Province ZIP / Postal Code PhoneWork Type / Job Title List Types of Work Experience Add RemoveVocational Training Church (or Organization)Name City Pastor PhoneDenomination Character ReferenceName PhoneHigh School Graduate? Yes No GED CollegeNumber of yearsDegree(s) Major Graduate SchoolDegree(s) Major Foreign languages spoken Add RemoveAre you currently an: Ordained Minister Licensed Minister Other credentials issued by which religious faith group? Please attach documentation (i.e. certificate of ordination)(Required)Max. file size: 32 MB.You must include a Pastoral Reference letter with your application to even be considered(Required)Max. file size: 32 MB.Are you a United States Citizen? Yes No Please attach documentation of current status Drop files here or Select files Max. file size: 32 MB. Do you have a physical disability? Yes No What? Do you have reliable transportation? Yes No Do you currently have any other certification or seminary degree's? Yes No Explain belowAre you currently on parole or probation? Yes No Are there any other names you have been known by? Yes No Please list Add RemoveHave you ever been through Deliverance or Inner Healing? Yes No What ministry? Do you currently hold any positions with other ministries? Why do you want to be a volunteer for the John G Lake Apostolic Healing Center?AvailabilityWeekdays Untitled a.m. p.m. Weeknights Weekends Untitled a.m. p.m. Consent(Required) I understand that a police records/criminal history check is a necessary security procedure for acceptance into this program. My signature below authorizes initial and periodic re-checks as deemed necessary for my continued participation and confirms my agreement to abide by all policies and procedures of the Department of Corrections and its administrative components, particularly those regarding ethical standards, security, and confidentiality of information. I understand that false and/or incomplete information will result in non-acceptance or discharge from this program. My signature certifies the truth and accuracy of the information provided herein. (Photocopies and/or faxes shall be as valid as the original.)Name(Required) First Last Date(Required) MM slash DD slash YYYY NameThis field is for validation purposes and should be left unchanged. 99859
