Mothers Helping Mothers Inc

Volunteer your time with Mothers Helping Mothers

Complete the Volunteer Application below.

Volunteer Application


CONTACT INFORMATION:


AVAILABILITY:

Please check all the days you are available to volunteer: (required)

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