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Individual Volunteer Application
Contact Information
Name
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First Name
Last Name
Email
*
Verify Email
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Phone
Address
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
I'm interested in volunteering as a:
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Comprehensive descriptions are available. Please select all that apply.
Patient or Client Advocate
Receptionist (Bilingual)
Receptionist
Medical Volunteer (nurse, sonographer, doctor)
Behind-the Scenes: Facility maintenance
Behind-the Scenes: Special event assistance
Behind-the Scenes: Photography/Videography
Behind-the Scenes: Donate new items for Baby Boutique
Behind-the Scenes: Advancement/Marketing team
Behind-the Scenes: Lights of Life prayer team
Languages Spoken (in addition to English)
Spanish
French
Haitian Creole
Other (please note below)
Date of Birth
(mm/dd/yyyy)
Educational Background
Are you currently employed?
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Yes - Full-time
Yes - Part-time
No
If employed, where?
Employment History
*
Church Affiliation
Are you married?
Married
Single
Widowed
Divorced
Spouse's Name
Children's names and ages (if applicable)
Hobbies, talents, interests
Volunteer experience
Pro-Life involvement
Have you ever been arrested? Is so, for what?
How did you hear of A Woman's Concern?
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I think abortion is ... (please complete)
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I want to volunteer at A Woman's Concern because ... (please complete)
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What I have to offer A Woman's Concern is ... (please complete)
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Reference: Please include name, phone number, how acquainted and for how long?
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I understand that A Woman's Concern requires a strong commitment. I am pledged to working one day a week and attending bi-monthly meetings. I understand that all information regarding my work at AWC is confidential.
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Yes
No