Volunteer Application "*" indicates required fields GENERAL INFORMATIONLegal Name* DOB* Preferred Name Gender* Female Male Other U.S. Citizen* Yes No Country of Origin* Green Card Number (Required for volunteers from outside US)Ethnicity (Optional) Address* Street Address City State / Province / Region ZIP / Postal Code Home PhoneCell Phone*WorkPhoneFAXFaith Affiliation (Optional) Church (Optional) Do you own a car? Yes No Are you a licensed driver? Yes No Do you have current auto insurance? Yes No (If so, please email copies of your current driver’s license and insurance to cbach@poorhandmaids.org.)EDUCATION (Please send a PDF file of your resume, including references and transcripts for degrees conferred to cbach@poorhandmaids.org.)Degree Year College / University High School or GED Year Trade / Correspondence School Year Post Graduate Degree Year Degree Special Study / Interest beyond formal schooling Professional License or Certification Professional Organizations to which you belongEMPLOYMENT HISTORY List your past three employers beginning with the most currentDates Position Name of Employer Phone NumberDates Position Name of Employer Phone NumberDates Position Name of Employer Phone NumberCurrent Employment For how long? If not employed, why? HEALTH INFORMATIONCurrent Diagnoses*Current Medications*Allergies* Dietary Restrictions* Restrictions for work or activities* EMERGENCY CONTACTSName* Relationship* Home PhoneCell Phone*Email Address* Name Relationship Home PhoneCell PhoneEmail Address Name Relationship Home PhoneCell PhoneEmail Address PERSONAL INFORMATION1. Describe your interests and hobbies.*2. How did you hear about the Poor Handmaids of Jesus Christ Volunteer Program?*3. Describe your familiarity with the PHJCs.*4. Describe your life experience in a faith community.*5. Why are you interested in becoming a volunteer at this time?*6. What do you hope to gain as a volunteer?*7. Have you ever been a volunteer before? If so, when and where? Please describe your role(s).*8. Do you speak another language?* Yes No If so, which? Limited Conversational Fluent 9. What skills and abilities do you have to offer as a volunteer?*10. Describe your involvement in community and church activities.*11. How do you see yourself as being open to the Spirit?*12. What are your hopes and concerns for community living with the Poor Handmaids of Jesus Christ? What would you like to learn by living intentional community?*13. What type of person would you find most difficult to live with? What might others find difficult about living with you?*14. What skills do you bring to the table for navigating community living?*15. How do you currently live a simple lifestyle? Are you open to learning more about living more simply?*16. In what ways would you like to challenge yourself to live simply in this time as a volunteer?*17. How do you currently show dignity and respect for all persons and creation?*18. What opportunities have you had to work with persons of different backgrounds and faith traditions (i.e., economic, social, financial, spiritual and sexually oriented backgrounds)? What would be your greatest challenge?*19. How have you experienced compassion in your life? How have you shown compassion to others?*Are you currently seeking placement with other volunteer organizations?* Yes No If so, with whom? Present status of application? 21. Please list and explain financial, family or personal obligations or situations which might impact your commitment to the PHJC Volunteer program.*22. What length of time do you wish to volunteer?* 3 months 6 months 9 months 12 months 23. Beginning when? MM slash DD slash YYYY Ending when? MM slash DD slash YYYY 24. Please send a current photograph to cbach@poorhandmaids.org25. Please write a mini-autobiography in response to the following question(s). Responses can be as long or short as you would like, but it is our intention to let these assist us in getting to know you.“Who are you?”*“How do you define your personality and character?”*“Highlight significant people and events that have shaped who you are today.”*“What is your sense of service?”*“How has service been a part of your faith experience?”*Rating Scale Please rate yourself on the following scale. Be as honest as possible, again to help us to get to know you better and find the right placement for you.WORK A FULL DAY* Great Ability Some Ability Little Ability No Ability Do Not Know WALK LONG DISTANCES* Great Ability Some Ability Little Ability No Ability Do Not Know TOLERATE DIETARY CHANGES* Great Ability Some Ability Little Ability No Ability Do Not Know DISPLAY FLEXIBILITY WITH SCHEDULES/PLANNING* Great Ability Some Ability Little Ability No Ability Do Not Know ADAPT TO DIFFERENT CULTURES* Great Ability Some Ability Little Ability No Ability Do Not Know FIND HUMOR IN DIFFICULT SITUATIONS* Great Ability Some Ability Little Ability No Ability Do Not Know RELATE TO PEOPLE WHO ARE VERY POOR* Great Ability Some Ability Little Ability No Ability Do Not Know LIVE A SIMPLE LIFESTYLE* Great Ability Some Ability Little Ability No Ability Do Not Know BE A SELF-STARTER/INITIATOR* Great Ability Some Ability Little Ability No Ability Do Not Know DEMONSTRATE TIME MANAGEMENT* Great Ability Some Ability Little Ability No Ability Do Not Know ACCEPT FEEDBACK IN A POSITIVE MANNER* Great Ability Some Ability Little Ability No Ability Do Not Know GIVE FEEDBACK IN A POSITIVE MANNER* Great Ability Some Ability Little Ability No Ability Do Not Know WORK AS A TEAM MEMBER* Great Ability Some Ability Little Ability No Ability Do Not Know BE CULTURALLY SENSITIVE* Great Ability Some Ability Little Ability No Ability Do Not Know GET ALONG WITH OTHERS* Great Ability Some Ability Little Ability No Ability Do Not Know COLLABORATE/COOPERATE ON A PROJECT* Great Ability Some Ability Little Ability No Ability Do Not Know HANDLE DIFFICULT SITUATIONS* Great Ability Some Ability Little Ability No Ability Do Not Know TOLERATE DIFFERENCES* Great Ability Some Ability Little Ability No Ability Do Not Know WORK WITH THE GENERAL PUBLIC* Great Ability Some Ability Little Ability No Ability Do Not Know HEAR DIVERSE PERSPECTIVES* Great Ability Some Ability Little Ability No Ability Do Not Know PARTICIPATE IN GROUP ACTIVITIES* Great Ability Some Ability Little Ability No Ability Do Not Know LEAD GROUP ACTIVITIES Great Ability Some Ability Little Ability No Ability Do Not Know SHARE FAITH/PRAY WITH A GROUP* Great Ability Some Ability Little Ability No Ability Do Not Know 26. Are you willing to undergo a background check?* Yes No 27. Are you willing to undergo a drug test?* Yes No 28. Are you willing to undergo fingerprinting?* Yes No List all arrests/criminal history outside the state of Indiana.*I attest that all information contained in this application is true to the best of my knowledge. Any misrepresentation or omission of any fact in my application, resume, or any other materials, or during any interviews, can be justification for refusal of acceptance or continuation in the program. In submitting this application I understand and agree that all materials become property of the PHJC Volunteer Program and that none of the materials will be returned to me. I also understand that my resume and all references will be reviewed by the partner agency(ies) for which I am being considered. **Application process does not guarantee acceptance into the program.Signature*Date* MM slash DD slash YYYY CAPTCHA
