Name *

First Name

Last Name

Phone *

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Date of Birth *

MM

DD

YYYY

Emergency Contact Phone *

First Name

Last Name

Have you ever worked with survivors of sexual exploitation or any kind of abuse? *

YES

NO

In which areas are you interested? *

Host a fundraising event

Host a Home party collecting donation items

Administrative Support

Marketing (Graphic Design/Social Media)

Volunteer at Community Events

Prayer Team

Yard work or handy work

Training Assistant

Storage Organization

Serve in the Safe House

Other

At what times are you available for volunteering? *

Weekdays

Weekends

Evenings

Flexible

One a month

4 times per year

One Time

Do we have your consent to run a background check?

YES

NO