Volunteer Application Form

Thank you for your interest in volunteering with our ministry. We are committed to providing a safe, compassionate, and supportive environment for women and children. Please complete the application below to help us learn more about you and your interests.

Click here if you prefer a Printable Version
The Jeremiah 2911 House Volunteer Application
Full Name for background check
Full Name for background check
First Name
Last Name
Preferred Contact Method
Which days are you available to volunteer?
Preferred time(s) of day:
Is this a short-term or long-term commitment?
Volunteer Interests (Check all that apply)
Have you ever been convicted of a crime?
Are you willing to undergo a background check?
Agreement & Signature I certify that the information provided is true and complete to the best of my knowledge. I understand that all volunteers may be required to undergo training and background checks prior to working with residents.