Year Long Volunteer Application Form

Year Long Volunteer Application
Personal Information
Name *

First Name Last Name
E-mail *
Phone Number *

Country Area Code Phone Number
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Date of Birth *

Month Day Year
Social Security No.
Country of Birth *
Country of Citizenship *
Gender *

Male Female
Marital Status *

Single Married Divorced
Photo

Upload a current photo of yourself
Parent / Guardian Information
Name *

First Name Last Name
Phone Number *

Country Area Code Phone Number
Email
example@example.com
Profile
Current Occupation
Name of School
Leave blank if you are not currently in school.
Highschool Graduation
Year
College Education Completed

Associate - 2yr Bachelors Degree Masters Degree
Availability *
Please indicate the dates for which are able to serve
Position Applying For *

Maintenance Kitchen Resident Assistant
If you are wanting to apply for a summer volunteer position, please exit this form and fill out the summer volunteer application.
Indicate any other positions you are also applying for (leave blank if none)
Skillsets, Abilities or Related Experience
i.e. outdoor skills, worship leading, maintenence, media, houskeeping, cooking or areas of leadership
Will You Bring Your Own Vehicle?

Yes No
Medical History

Please indicate any of the following you have experienced:
Allergies (food, drug, pollen, insect bites, etc.) *

Yes No
Diabetes or hypoglycemia *

Yes No
Epilepsy *

Yes No
Heart problems *

Yes No
Have you had an emotional or mental breakdown at any time? *

Yes No
Have you had any professional psychological counseling? *

Yes No
Have you been in the past or are you currently suffering from anorexia or bulimia? *

Yes No
Have you been in the past or are you currently a user of alcohol, tobacco or recreational drugs? *

Yes No
Have you ever experienced (check all that apply):

Excessive Nose Bleeds High Altitude Sickness Asthma Broncitis High Blood Pressure Ulcers
Explain in detail any “YES” answers:
List any medical problems, illnesses or chronic conditions experienced in the last three years:
List any medications you are currently taking:
Age *
Height *
Weight *
Health Condition *
Current Health Physician:
Name *
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number *

Area Code Phone Number
Emergency Contact:
Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number *

Area Code Phone Number
Relationship to Applicant *
Insurance Provider / Group Name *
Policy Number *
I certify that the above medical information is correct to the best of my knowledge.
Signature *

Clear

Christian Experience
Please give a brief account of your acceptance of Jesus Christ. *
How has the Lord been working in your life recently? *
What are your reasons for wishing to participate in our Internship Program? *
Please explain any past experience you have in ministry settings. *
Describe any Christian service or work specifically in a position of leadership. *
Please give the name and address of the church you attend. *
I understand and agree with the General Information items and accept them as my responsibilities. I will accept the decisions of the director and staff in all matters pertaining to the Internship Program and will submit to the authority and discipline of Ravencrest Chalet.

“Any applicant who knowingly or willfuly makes a false statement of any material fact or thing in the application is guilty of perjury in the second degree as defined in Section 18-8-503, C.R.S., and, upon conviction thereof, shall be punished accordingly.”
Signature *

Clear
Should be Empty: