Ezra Centre

VOLUNTEER APPLICATION FORM
(All information will be treated in confidence)

* SURNAME:

* FORENAME:

* NATIONALITY:

* ADDRESS:

TELEPHONE

HOME:

BUSINESS:

MOBILE:

* E-MAIL:

OCCUPATION:

DATE OF BIRTH:

QUALIFICATIONS (if any):

POSITION APPLYING FOR:

CAR OWNER:

MAKE/MODEL:

REG. NO.:

Do you have any medical condition/illness that might affect your work as a volunteer? If yes, please give details:

Have you done voluntary work in the past? Please give details:

How did you hear about the Ezra Centre Volunteers?

Why have you chosen to seek a volunteering opportunity with the Ezra Centre?

Have you had any experience, personal or otherwise, with similar ministries?

TIME AVAILABILITY

REFEREES (All Applicants)

(1) Name:

Address:

Telephone No.:

Position held:

(2) Name:

Address:

Telephone No.:

Position held:

Please note your referees will be contacted before we meet with you.

Any other comments you would like to add:

I declare that the information I have given is, to the best of my knowledge, true and accurate.