Volunteer Application
Hope Center with two locations in
Grangeville and Kamiah ID
Name ______Address ______
City ______State ______ZIP ______
Phone (Day) ______(Evening) ______e-mail ______
Occupation ______Age______Marital Status ______
What position are you volunteering for? ______
Why do you want to serve in this position? ______
What is your previous volunteer experience (if any)? ______
How much time can you give to this service? ______
Is your spouse supportive of your desire to volunteer for this position? ______
Please provide the following information. If there are any questions you would prefer not to answer in writing but would discuss confidentially with the interviewer please indicate "confidential". If there is not enough space to answer a question please use the back of the page.
1. Do you consider yourself a Christian? Yes ___ No ___ How long have you been a Christian? ______
2. What is a Christian? ______
3. How did you become a Christian? ______
(Please write a brief testimony on the back of this page)
4. What church do you attend?______
Denomination______
Are you a member of this church? Yes ___ No ___ How long have you attended or been a member? __
Church Address ______City ______ZIP______
Pastor's name ______Phone ______
How often do you attend services? ______
How have you matured in the Christian Life? ______
______
What positions have you held or service performed in the church? ______
______
5. Please share something about your daily walk with the Lord?______
6. How much formal education have you received?______
7. What special gifts and talents do you have? ______
8. What special personality traits do you have for this ministry? ______
9. A) Have you ever counseled a woman who was considering an abortion? Yes ___ No___
B) Have you ever counseled a woman who had an abortion? Yes ____ No ____
C) What were the results of your counsel? ______
10. Have you ever had a traumatic experience related to abortion? Yes ___ No ___ Explanation______
______
11. Have you ever been convicted of child abuse or of any sexually related crime? Yes ___ No ___ Explanation______
12. Were you a victim of abuse or molestation as a child? Yes ___ No ___ Explanation______
______
13. Have you ever had a homosexual lifestyle? Yes ____ No ____ Explanation? ______
15. Are you currently involved in trying to adopt a child? Yes ____ No ____
16. Are there any personality types you have difficulty working with? ______
17. Under what circumstances would you consider abortion as an acceptable alternative for a woman with a crisis pregnancy?
A) In cases of rape/incest ____;
B) In cases of extreme severe psychological stress ____;
C) Other, (explain) ______
D) Never an option ____ .
18. At what age or under what circumstances do you feel that it would it be acceptable for a person to become sexually active?
______
19. How would you rate yourself in the following areas:
a. Knowledge of methods used to perform abortions.
Excellent _____ ; Good _____ ; Fair ____ ; Poor ____
b. Knowledge of existing laws regulating abortion.
Excellent _____ ; Good _____ ; Fair ____ ; Poor ____
c. Knowledge of what the bible teaches (directly or indirectly) about abortion.
Excellent _____; Good _____; Fair _____; Poor _____
20. Please list any books, audio visuals or other materials that you have read or viewed that relate to abortion, pregnancy, or alternatives to abortion. ______
21. Have you ever attended a training seminar for volunteer workers in a pregnancy center? Yes __ No __
22. Are you willing to commit yourself to attending such a seminar? Yes ____ No ____
- Regardless of any personal doctrinal differences will you agree to work in Christian unity to further the work of Hope Center? Yes _____, No _____
- In the future our insurance carrier or law may require an F.B.I. background check. Would this be acceptable to you? Yes _____, No _____
Volunteer Applicant Personal References
Only one of the following references may be a family relative.
1. Name ______Home Phone ______
Address ______Work Phone ______
City ______State ______ZIP ______
How long have you known this person? ______
What has been your relationship with this person? ______
Is your contact and relationship current? ______
2. Name ______Home Phone ______
Address ______Work Phone ______
City ______State ______ZIP ______
How long have you known this person? ______
What has been your relationship with this person? ______
Is your contact and relationship current? ______
3. May we also use your senior pastor as a personal reference? Yes _____, No _____
If not previously provided, please give the following contact information:
Senior Pastor’s Name ______
Church ______
Address ______
Phone: Church office ______Home ______
Our Commitment of Care
1. Clients are served without regard to age, race, income, nationality, religious affiliation, disability or other arbitrary circumstances.
2. Clients are treated with kindness, compassion and in a caring manner.
3. Clients always receive honest and open answers.
4. Client pregnancy tests are distributed and administered in accordance with all applicable laws.
5. Client information is held in strict and absolute confidence. Client information is only disclosed as required by law and when necessary to protect the client or others against imminent harm.
6. Clients receive accurate information about pregnancy, fetal development, lifestyle issues, and related concerns.
7. We do not offer, recommend or refer for abortions or abortifacients, but we are committed to offering accurate information about abortion procedures and risks.
8. All of our advertising and communications are truthful and honest and accurately describe the services we offer.
9. All of our staff and volunteers receive proper training to uphold these standards.
My signature on this Commitment of Care of Heartbeat International, Inc. which is endorsed by Hope Center indicates my agreement with it.
Signature: ______Date ______
STATEMENT OF FAITH
I believe in God, the Father Almighty,
the Maker of heaven and earth,
and in Jesus Christ, His only Son, our Lord:
Who was conceived by the Holy Ghost,
born of the virgin Mary,
suffered under Pontius Pilate,
was crucified, dead, and buried;
He descended into hell.
The third day He arose again from the dead;
He ascended into heaven,
and sitteth on the right hand of God the Father Almighty;
from thence he shall come to judge the quick and the dead.
I believe in the Holy Ghost;
the holy christian church;
the communion of saints;
the forgiveness of sins;
the resurrection of the body;
and the life everlasting.
Amen.
My signature indicates my agreement with this Statement of Faith.
Signature:______Date______
Mission Statement for Hope Center
Adopted July 9, 2012
Hope Center is a non-denominational Christian ministry, with locations in Grangeville and Kamiah, Idaho, providing "hope" for today and the future by offering free and confidential:
- Educational classes with practical solutions on parenting and relationships
- Spiritual comfort, emotional support, and referrals for family concerns
- Infant and toddler supplies for clients
- Sexual integrity, personal safety, and abortion alternatives and recovery assistance
to meet the needs of individuals and families in Idaho, Lewis, and Clearwater Counties.
My signature indicates my agreement with this Mission Statement.
Signature: ______Date______
Hope Center endorses the principles of Heartbeat International. Our volunteer workers are expected to accept these...
Principles
1. Heartbeat affiliates propose and offer, through education and creative services, positive choices for the woman challenged by pregnancy.
2. Heartbeat affiliates shall not discriminate in their services on the basis of race, creed, color, national origin, age, or marital status.
3. Heartbeat affiliates services are personal, confidential and non-judgmental.
4. Heartbeat affiliates shall not advise, provide, or refer for abortion or abortifacients.
5. Heartbeat affiliates encourage chastity as a positive lifestyle choice.
My signature indicates my agreement with these principles.
Signature: ______Date______
Volunteer Applicant Agreement
Recognizing that Hope Center is a non-denominational evangelical Christian ministry, I acknowledge my personal faith in Jesus Christ as my Savior and the Lord of my life. It is my greatest desire to live a holy life in His will, to serve Him and to share His love and grace with others as I have opportunity to do so. In this spirit I volunteer my services to Hope Center. I understand that clients of the center may be given the gospel message and invited to accept Christ as their personal savior without any recommendation to attend any particular church.
I believe in the sanctity of human life as taught in the Holy Bible and, therefore, reject abortion as an acceptable option for any woman facing an unwanted pregnancy.
I accept my responsibility to point and lift womanhood and manhood to the highest standards of life by precept and example. To this end I will serve the Centers. As I may have contact with clients of the center I will treat them in a kind, caring, courteous manner showing no discrimination whatsoever due to their circumstances, age, color, creed, gender, race or nationality. If I am in a position to give information or to counsel I will give accurate information, emotional support and spiritual guidance. All information concerning clients will be kept confidential even when I am no longer a volunteer worker for the Centers.
Understanding the vital role and the necessity of team effort in the volunteer work of the centers, I commit myself to serve faithfully on a regular basis, according to the schedule agreed upon. When I may be prevented from doing my service due to unavoidable or unforeseen circumstances I will notify the appropriate responsible party as quickly as possible so that a substitute may be found to perform the duty. I will be diligent to attend volunteer staff meetings and in-service meetings and if unavoidably absent I will take responsibility to obtain missed information.
I have read the Statement of Faith, Mission Statement, the Principles, and the Commitment of Care of the Center and of its umbrella agency and agree to uphold them at all times. I will also uphold the policies and procedures as established by the Board of Directors. I agree, regardless of doctrinal differences, to work in unity with others in the Center. If, at any time, I should come to feel that I cannot conscionably endorse any statements of principles, policy or faith, I will courteously, without prejudice, with ample time for replacement, give notice of resignation from my duties.
I certify that the facts set forth in this volunteer application are true and complete to the best of my knowledge, and I authorize the Center to verify their accuracy and to obtain reference information concerning my character and capabilities. I release Hope Center and any person or entity providing such reference information from any and all liability relating to the provision of such information or relating to any decisions made based upon such information.
Signature of Applicant ______Date ______