Volunteer Application Form

Eyes On Me, Inc

Volunteer Application
Name*

First NameMiddle NameLast Name
Date Of Birth*

MonthDayYear
E-mail
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Do you have a valid drivers license?*

YesNo
Do you have reliable transportation for use while volunteering?*

YesNo
Experience and Education
List any relevant educational/training background.
List any relevant employment history.
List any previous relevant volunteer experience.
Have you completed any EOM training programs?*

Yes, I know how to make reproducible DisciplesNo, but would like to find out when the next training session is
How frequently are you interested in volunteering?

One timePeriodicalOngoing
What days are you available?

MondayTuesdayWednesdayThursdayFridaySaturdaySunday
What times are you available?

MorningsAfternoonsEvenings
In what areas are you interested in serving? (Check all that apply)*

Outreach/EvangelismDiscipleshipMentoringAdministrativeTrade Programs
Which programs are you interested in volunteering with? (Check all that apply)*

Hip Hop HopeDisciple The StreetsMentoringPrison OutreachSchool AssembliesAdministrationThe Hangar (Brookshire, TX)Out Tha Box ChurchOther _________
In what areas are you interested in Volunteering? (Addresses listed are Hip Hop Hope locations only)*

5th Ward: Cleme Manor Apartments-5300 Coke St. 2nd & 4th Tuesdays 6:30-8:30Forum Park(Alief) The Carlise Apartments-9898 Forum Park Dr. 1st & 3rd Wednesday 6:30-8:30Brookshire: 4010 4th Street, Brookshire, TX 1st & 3rd Thursdays 7-9Greenspoint: Thicket Apartments-13011 Northborough Dr. 2nd & 4th Thursday 6:30-8:30Sunnyside: Kings Row Apartments-4141 Barberry Dr 2nd & 4th Friday 6:30-8:30Other
List any relevant skills, capabilities, strengths that you believe would be BENEFICIAL When VOLUNTEERING?
Other languages spoken fluently?
Do you have any needs or restrictions we should be aware of?
Date you can begin service?
Criminal History
All volunteer positions require a Criminal History Check. Convictions will not necessarily disqualify you from participating. (Remember, we work with ex-convicts)
Have you ever been convicted of a felony?

YesNo
If yes, please explain
By checking here I consent to a full background check with Eyes On Me, Inc.*

I consent
Upload Background check form *

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Eyes On Me, Inc

Experience and Education

Criminal History

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