This introductory application allows Volunteer Ministries staff to get to know the experiences and skills you offer for a volunteer placement. Completion of this form begins the application process but does not commit you to participation nor guarantee placement. Volunteer Ministries staff will electronically send you the second part of the application and forms for written references.
Title
Last Name
First Name
Address
City
State
Zip Code
Country
Phone
Cell Phone
Do you use Texting?
Yes Texting
No texting
Fax
E-mail Address
Date of Birth (mm/dd/year)
EMERGENCY CONTACT (Person who can always reach you)
Name
Address
City
State
Zip Code
Phone
Cell Phone
Fax
E-Mail
Your Availability for a Placement with a Young Adult Service Community
September 4, 2012 - August 4, 2013 Young Adult Service Communities
Types of Skills and Experience You bring (Check all that apply)
Languages Spoken or Written
Hospitality Your Experience:
Communications Your Experience:
Financial Management Your Experience:
Office Skills Your Experience:
Database Development Your Experience:
Agriculture/Environment Your Experience:
Building Trades Your Experience:
Community Organizing Your Experience:
Direct Social Service Your Experience:
Case Management Your Experience:
Instruction/Teaching Your Experience:
Driver's License Class:
Possible Service Settings ( Indicate Interest by 1, 2, 3, 4, 5 with 1 as little interest and 5 as great interest.)
Immigration & Border Ministries
Inner City Ministries
Elders
Children
Homeless Shelters
Food Programs
Worker's Rights
Direct Social Service
Community Organizing
UCC wider church
Other
Please Explain:
UCC Young Adult Service Communities in Network
Locations in Order of Preference:
September 4, 2012 - August 4, 2013
Setting: Child Care, Retirement Community Program Assistant, Refugee and Immigration Services, Case Worker
September 4, 2012 - August 4, 2013
Setting: UCC Conference & Association Youth/Young Adult Networking; local community agencies.
September 4, 2012 - August 4, 2013
Setting: Justice Advocacy Agencies and intensive justice leadership training.
September 4, 2012 - August 4, 2013
Setting: Public school connections and food security programs.
September 4, 2012 - August 4, 2013
Setting: Case workers, Community Organizer
August 12, 2012 - June 30, 2013
Setting: Case worker, Community Organizer
September 2012 - August 2013
Setting: Washington, DC-Case Workers fields of health care, homeless populations, social services
WVC has a separate application procedure. Go to www.westmorelanducc.org
How did you learn or hear about this program?
