Personal:

• Full Name:_________________________________________________________________________
• Email:__________________________Home Phone:________________Cell#:__________________
• Present Address:____________________________________________________________________
• ______________________________________________________________________
• Birth date: _______________________ (year is optional if you're over 18)


• Person to notify in case of emergency:____________________________ Phone: _________________
• Current Occupation: _____________________________Employer:_______________________________
• Students: please list school, current year, and year of graduation:__________________________________

Volunteer Interests:

• Circle where you'd like to serve:
• TUTORING: Johnson K-4^th or Walker 5-6^th or Buford 7-8^th or CHS 9-12^th
• OTHER PROGRAMMING: Bible Club or IG Club or LQ Jr. Club or LQ Sr. Club or 5/8 Club or Elevate or UDCC or Other
• BACKGROUND SUPPORT: Board Member or Clerical Help or Data Entry Help or Computer Help or Spanish Translation
• Languages you speak/understand: __________________________________________________________
• List any Christian or Service Organizations you have been involved in: ______________________________________

Spiritual:

Physical:

Legal:

Have you ever been convicted of a felony or misdemeanor (other than a minor traffic violation)? Yes or No (circle one). If yes, please explain: ____________________________________________

____________________________________________________________________________________

Have you ever been convicted of child abuse or of a crime involving the actual or the attempted molestation of a minor?  Yes or No (circle one). If yes, please explain: _______________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

Help us to get to know you better:

Describe why you feel called to serve at Abundant Life Ministries, and the primary gifts/skills/interests you bring to the ministry:

____________________________________________________________________________________

____________________________________________________________________________________

List any other abilities, training, education or previous ministry experiences which have prepared you for your service with Abundant Life Ministries:

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

REFERENCES 

Please provide three (3) references, unrelated to you, who have known you for several years.  Examples: teacher, pastor, employer (past/present), co-worker, coach, mentor. If you have prior volunteer experience, please include a reference from that organization. Please include a FULL ADDRESS for each one. Please write legibly!

Name: ______________________________________________  Email: _________________________

Organization (if applicable):______________________________ Title: __________________________

Address: _____________________________________________ Phone: _________________________

City/State/Zip: ________________________________________   

Relationship to applicant: ________________________________ Years known: ____________________

Name: ______________________________________________  Email: __________________________

Organization (if applicable):______________________________ Title: ___________________________

Address: _____________________________________________ Phone: __________________________

City/State/Zip: ________________________________________

Relationship to applicant: ________________________________ Years known: ____________________

Name: ______________________________________________  Email: __________________________

Organization (if applicable):______________________________ Title: ___________________________

Address: _____________________________________________ Phone: __________________________

City/State/Zip: ________________________________________

Relationship to applicant: ________________________________ Years known: ____________________

APPLICANT'S STATEMENT

The information contained in this application is correct to the best of my knowledge, and I authorize Abundant

Life Ministries to check my references. I authorize any references or churches listed in this application to give

you any information (including opinions) that they may have regarding my character and fitness for ministry

ervice. I release all such references from any liability for furnishing such evaluations to you, provided they do

so in good faith and without malice. I waive any right that I may have to inspect references provided on my behalf.

If my application is accepted, I agree to be bound by the Bylaws and policies of Charlottesville Abundant

Life Ministries, and to refrain from unscriptural conduct in the performance of my services on behalf of the ministry.

Applicant's Signature: ___________________________________ Date: __________________________

Signature of someone who witnessed your signature: ___________________ Date: ___________________