Volunteer Application Please enter only safe contact information Name: Mailing Address (including city, state, ZIP and Apt. #): Home Telephone Number: Cell Number: Work Number: E-mail Address: Preferred contact: H PHONE WK PHONE CELL EMAIL Birthdate: Gender: Ethnicity: Do you speak Spanish? YES NO Are you a Christian? YES NO Church Name/Address Driver’s License #/ S.S. # (for background check purposes): How did you here about us? Have you experienced family or domestic violence or sexual assault? If so, please explain. What areas within the ministry are you interested in (youth advocacy, elderly abuse, prevention, booth/safety fairs, counseling, self-sufficiency classes, direct services to clients, food pantry, etc.)? What personal skills do you possess that can help our efforts? Have you ever been convicted of a crime against a child? Have you ever been charged or convicted of a felony? I attest that all the information above is true and accurate and I authorize the county or state facility and/or the ministry to conduct a criminal background check to verify this information. _________________________________ ______________________________ Signature Date Please mail this application to Delivered Out Ministries, c/o Loving Fellowship Baptist Church, 602 W. Wheatland Road, Duncanville, Texas 75116.