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Contact Information
Name
*
First Name
Last Name
Email
*
Verify Email
*
Phone
*
Address
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
How did you hear about Peace House Community?
Interests
What areas of PHC's work are you interested in joining? (Check all that apply)
Welcoming Community Members
Maintenance and Facilities
Board of Directors/Administration
Donor Relations and Cultivation
Special Events
Other
Areas of Interest
What other areas of PHC's work are you interested in?
Organization/Employer
I am over 18 years of age
Yes
No
Emergency Contact Information
Do you want to be added to PHC's mailing list?
Yes
No
Signature
*
Signature I affirm that the information I have given on this form is true and correct. The information that I have provided may be verified by contacting persons or organizations named in this application. Peace House Community will conduct a background check. I am donating my time for personal reasons and understand that I will not be paid for my services, and I expect no compensation. Furthermore, I understand that this application will help in determining the best fit for my skills at Peace House Community.
Date
*
(mm/dd/yyyy)