Volunteer Application

PERSONAL INFORMATION

Title

First Name *

Last Name *

Email Address *

Home Phone Number *

Cell Phone Number

Date of Birth *

Gender
Male
Female

Marital Status

PERSONAL HISTORY

Short Testimony *

Ministries or service work you are involved in:

Home Church

City/State

How long have you attended?

Education

Please include any gifts or skills you feel would be useful in serving at one of the Hands and Feet Project's Children's Villages

Employment

MISSIONS EXPERIENCE

Hands and Feet Referring Field Director

Have you already been in contact with one of our field directors in Haiti?

Have you visited the Hands And Feet site before? *
Yes
No

Have you been to Haiti before? *
Yes
No

Have you been on a mission trip before? *
Yes
No

Location willing to serve: *

Approximate placement date: *

Please let us know during what month and year you are interested in serving at Hands and Feet Project

Length of Service - From: *

To: *

Please list any foreign languages you speak, if any:

Expectations *

What do you expect to learn or achieve while serving at Hands and Feet Project?

EMERGENCY CONTACT INFO

Name *

Address *

City *

State *

Zipcode/Postcode *

Country *

Phone Number *

Emergency Contact Email *

PASSPORT

Legal Name on Passport *

Passport Number *

Passport Expiration Date *

HEALTH HISTORY

Are you in good health? *
Yes
No

Please explain any conditions:

Do you take any medications?
Yes
No

Please list medications:

REFERENCES

Please include one pastor or church leader.

First Name

Last Name

Position and Relationship

Email

Phone

First Name

Last Name

Position and Relationship

Email

Phone

First Name

Last Name

Position and Relationship

Email

Phone