Volunteer Application/Commitment Form

Volunteer Application/Commitment Form

Thank you for your interest to volunteer at the HOPE Respite Program at Englewood Presbyterian Church in Rocky Mount, N.C. If you feel you can become a friend to a child or teenager who has a disability and that you can commit to participate the first Saturday of every month, then the HOPE program may be a wonderful opportunity for your life.

Please complete the information below and return it to:

Englewood Presbyterian Church

100 S. Englewood Drive

Rocky Mount, N.C. 27804

ATTN: HOPE Respite Program

Thank You,

Rebekah Brown, HOPE Program Coordinator

252-469-0722

NAME ______

AGE ______

PARENT(S) ______

PHONE ______

EMERGENCY NUMBER ______

I, ______, commit to volunteer my time and talent to the HOPE Respite Program the first Saturday of each month.

______

Volunteer

______

Date

______

Parent Signature if under age 18

I would like to participate in the following ways: (circle your choices)

Read Draw/Paint

Play an Instrument Dance

Tell stories Do Puzzles

Sing/Dance Participate in PE Games