Volunteer your time with Mothers Helping Mothers Complete the Volunteer Application below. Volunteer Application CONTACT INFORMATION: Your Name (required) Your Email (required) Mailing Address (required) City (required) State (required) Zip code (required) Phone (required) AVAILABILITY: Please check all the days you are available to volunteer: (required) MonTueWedThuFriSatSun What hours are you available to volunteer on the day(s) listed above? (required) FROM TO Please list areas in which you would like to volunteer: (required) PRE-SCREENING QUESTIONS: YesNo Have you used drugs in the past 12 months? YesNo Do you smoke cigarettes? YesNo Have you consumed alcohol in the past 12 months? YesNo Are you currently dealing with any issues of sexual immorality? YesNo Are you presently in treatment? If "Yes", where? YesNoHave you ever been in an alcohol, drug, or detoxification program before? If "Yes", please list the facilities If you would like to provide an explanation of any of the questions you responded to above, please do so in this area: LEGAL HISTORY: Please answer the following questions regarding any past legal history. Have you ever been arrested or incarcerated? (required) YesNo If "Yes", how many times? Please explain any charges or arrests below. ACCEPTANCE AND ACKNOWLEDGEMENT By completing this application, I certify the information provided is true and accurate. I authorize MHM to verify the validity of this application and any information contained within. I further give MHM authorization to run a background check to verify my legal history. I understand that any false or misleading information could result in my inability to volunteer with MHM. I further acknowledge that Mothers Helping Mothers is a nonprofit organization with a spiritual foundation. I agree to uphold the standards, ethics, and values of the organization at all times. Δ
