Respect Life Office
I came that they might have life and have it to the full  -  John 10:10

VOLUNTEER APPLICATION

RESPECT LIFE OFFICE

ARCHDIOCESE OF MIAMI

Dear Volunteer:

Thank you for offering your time and talent to work with the Respect Life Ministry. Volunteers such as yourself are indispensable to our program.

We would ask you at this time to fill out the following questionnaire. Because some of our ministry may include working with minors, it is necessary that we make appropriate inquiries of those to whom the care of others is committed.

Please supply the information requested below and return this form to the co-directors in charge of the particular office where you will be associated.

Please indicate which Respect Life Office you would like to Volunteer and/or be affiliated with:

( ) North Dade - SW  Broward Respect Life Office 3268 South University Drive Miramar, FL 33021 Phone Miami: 305-653-2921
Broward 954-436-3355

( ) Sunset Office- 9360 SW 72 St., #238, Miami, FL. Phone: 305-273-8507

( ) North Broward Office - 5115 Coconut Creek Pkwy, Margate, FL. 33063 Phone: 954-977-7769

( ) Ft. Lauderdale Office - 2909 N. Andrews Ave., Wilton Manors, Fl. 33311 Phone: 954-565-8506

( ) Hollywood Office - 5600 Hollywood Blvd., Hollywood, Fl. 33023 Phone: 954-963-2229

 

PLEASE PRINT Date _________________________

Name _____________________________________________Social Security # ____________________

Address _______________________________________City _____________________Zip___________

Date of Birth ____________________Home Phone __________________Work Phone ______________

Email Address: ________________________________________________________________________

Drivers License No. _____________________________________________State __________________

Parish/Church of affiliation _______________________________________

Family Status: Single ______ Married _______ Children #_________

Name of Spouse _________________________________

Your Occupation:____________________________ Spouse’s Occupation ________________________

Education Background ________________________ Degrees __________________________

Prior Volunteer Experience ______________________________________________________________

____________________________________________________________________________________

Organizations you belong to: _____________________________________________________________

____________________________________________________________________________________

Areas of Special Interest: Counseling ______ Speakers Bureau _______ Fund Raising ______

Office work ______ Baby Room ______ Hotline ______ Legislation ______

Hours of availability for service __________________________________________________________

Please describe in your own words what prompted you to volunteer your services for this program

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

Personal References: (3 non-family members)

Name Address Phone

1.___________________________________________________________________________________

2.___________________________________________________________________________________

3.___________________________________________________________________________________

  1. The information I have provided may be verified.

  2. In signing this application, I affirm that the information I have given is true and correct.

  3. If I am involved in the counseling aspects of this ministry, I agree to be fingerprinted.

Signature of Applicant _________________________________

IF YOU WILL BE COUNSELING OR REPRESENTING THE ARCHDIOCESE THROUGH PUBLIC SPEAKING AN ADDITIONAL REFERENCE BY YOUR PASTOR IS REQUIRED:

Signature of Pastor ____________________________________

Date ________________