Pink Cross Foundation Volunteer Application Form

Personal Information

First Name: *

Last Name: *

Middle Name:

Date of Birth: *

Age Range:

Gender: *

Title:

Contact Information

Street 1: *

Street 2:

Country: *

City: *

State: *

Zip/Postal Code: *

Home Phone: *

Ok to call me here.

Work Phone:
Ok to call me here.

Email Address: *

Availability

Please indicate the days and time periods that you are generally available to serve. You may provide additional information regarding your availability in the space below.

My Availibility is: *

Start:

End:

Additional Information:

Education

Education: *

Major:

Employment

If you are currently employed please fill out the form below.
If you are not currently employed, please indicate if you are retired, a homemaker or home educator, etc. in the first box. You need not duplicate your own contact information.

Employer/Company Name: *

Street 1:

Street 2:

City:

State:

Zip/Postal Code:

References

List one non-family reference who have known you for at least one year.

First Name: *

Last Name: *

Title:

City: *

State: *

Zip/Postal Code: *

Day Phone:

Evening Phone:

Email Address:

Relationship: *

Church References

Church Names: *

Christian Testimony

If you are a Christian please share your testimony below of how Christ has saved you or healed you from pornography, illness, etc. We love testimonies!

Testimony:

Why You want to Serve Pink Cross Foundation

Please share why you feel called to serve Pink Cross Foundation. We would love to know your heart.

Reason: *

Waiver and Release of Liability

In consideration of being allowed to volunteer my services at the Pink Cross Foundation, I hereby acknowledge that there are certain risks of injury involved, and I knowingly and freely assume all such risks and assume full responsibility for my participation. To the extent allowed by law, I agree to indemnify and hold harmless Pink Cross Foundation, its officers, employees, agents, representatives and volunteers, of all liabilities and all loss or damage to person or property which may occur or be incident to my involvement or participation.

Volunteer Confidentiality Agreement

I recognize that as a volunteer of Pink Cross Foundation, a California non-profit corporation, I may have access to confidential information concerning Pink Cross Foundation, its clients, customers, agents, employees, volunteers or representatives. In consideration of any volunteer status with Pink Cross Foundation, I agree I will not at any time, during or after volunteering for Pink Cross Foundation, divulge or reveal to any person, firm, or corporation, any information (including, but not limited to, personal or financial information or customer lists), directly or indirectly, which might in any way be used to injure or interfere with the business or ministry of Pink Cross Foundation, or to alienate clients, customers, agents, employees, volunteers or representatives from Pink Cross Foundation or to cause discontent or dissatisfaction among any such persons.

BY CHECKING THE FOLLOWING "I AGREE" BOX, I UNDERSTAND THAT I AM INDICATING MY AGREEMENT WITH THE TERMS OF ALL THREE PRECEDING SECTIONS.

Please Check: *

I Agree

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