Name __________________________________________________

Address ________________________________ City, State ZIP __________________________________

Home Phone ____________________ Work Phone ____________________ E-Mail ____________________

Place of employment (occupation) __________________________________________________________

Church attending ____________________________________ Pastor ______________________________

Office Assistance					Special Events

	( ) Mailings					( ) Information Table at Event
	( ) Data Entry					( ) Church or Organization Contact
	( ) Cleaning					( ) Speaking Engagements
	( ) Making Phone Calls				( ) Fundraising
	( ) Sort and Inventory Donations		( ) Be Involved in WCCH Auxiliary	

Resident Assistance
	Note:  Some positions or activities require that you complete some 
	       basic training and or authorize a background check.

	( ) Overnight Volunteer 			( ) Transportation
	( ) Peer Counseling				( ) Mentoring						0 Testimonial presentation				0 Teaching Life Skills
	( ) Prepare & demonstrate a meal preparation	( ) Teach a hobby or craft 	

Home Maintenance					Provide Special Services
	( ) Indoor (handyman, spring cleaning)		( ) Grant Writing
	( ) Outdoor (lawn care, etc.)			( ) Other

Spiritual Support
	( ) Pray for Women’s Care Center residents, staff and Board members.

Weekend Volunteer
	( ) 8:00A.M. Saturday to 8:00A.M. Sunday	( ) 8:00A.M. Sunday to 8:00A.M. Monday

Additional Information
	On the another paper, briefly describe your skills, spiritual gifts, talents or
	personal interests.  
	Please comment on any previous volunteer experience and include the organization 
	name and service provided. 
	Please list two references that we may contact.

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