We need you! Fill out the form and let’s do this!Note: All applicable fields need to be filled out for the application to be considered complete.OR download the volunteer form and drop it off at the Crossroads Care Clinic. Name * First Name Last Name Address Address 1 Address 2 City State/Province Zip/Postal Code Country Email * Phone (###) ### #### Date Of Birth * Marital Status * Single Married Widow Divorced Spouse First Name Last Name Children Do you have school age children at home? Yes No Names & ages of children under 18. Employment Background Occupation * How long have you worked for this company? * * Full Time Part Time Previous work history (Past 3 years) Company Name & How Long Highest level of education * High School Trade School College Bachelor's degree Master's degree Doctorate degree List any special training, areas of concentration, biblical studies, or educational experiences. Training and Gifts * What are your strengths? What are your possible areas of weakness? * What personality types do you have difficulty working with? * Christian Walk Do you consider yourself to be a Christian? * If yes, please explain what it means to be a Christian. How long have you been a Christian? * Briefly give your personal testimony. How has your life changed since your personal relationship with Jesus Christ began? * Which church do you attend? * Church & Pastor's Name How long have you been involved at your church? * General Information How did you hear about the Crossroads Care Clinic? * What is your reason for wanting to get involved with Crossroads Care Clinic? * Have you ever counseled a woman who was considering an abortion? * Under what circumstances, if any, would you consider abortion as an alternative for a woman with a crisis pregnancy? * Never an option Life of the mother Rape/incest Extreme psychological stress Other Have you had any traumatic experiences related to abortion? * How do you feel about a single woman parenting her baby? * Are you currently seeking to adopt a child? * When do you feel sexual intercourse is morally permissible? * What are your feelings regarding birth control for teenagers or single adults who are sexually active? * Where do you feel most led to serve at Crossroads Care Clinic? Please check all that apply Front Desk (Greeter) Prayer Team Client Advocate Baby Boutique Medical Professional TruthGirlz Mentor Other If you chose "other" please explain. References Name (Spiritual Reference) * First Name Last Name Email * Phone * (###) ### #### Name (Professional Reference) * First Name Last Name Email * Phone * (###) ### #### Name (Personal Reference) * First Name Last Name Email * Phone * (###) ### #### Core Values and Certification Core Values * Click on each core value to demonstrate that you are aware of and in agreement with Crossroads Care Clinic's values and Statement of Faith. I believe that life begins at conception and matters deeply to God. I believe that sexual intimacy is a gift from God and honors Him when enjoyed in marriage. I believe the Bible to be the inspired, infallible, authoritative Word of God. I believe there is one God, eternally existent in three persons; Father, Son, and Holy Spirit. I believe in the Deity of our Lord Jesus Christ, in His virgin birth, in His sinless life, in bodily resurrection, in His ascension to the right hand of the Father, and in His personal return in power and glory. I believe that for the salvation of the lost and sinful man, regeneration by the Holy Spirit is absolutely essential, and that this salvation is received through faith in Jesus Christ as Savior and Lord and not as a result of good works. I believe in the present ministry of the Holy Spirit by whose indwelling the Christian is enabled to live a godly life and to perform good works. I believe in the resurrection of both the saved and the lost; they that are saved unto the resurrection of life and they that are lost unto the resurrection of damnation. I believe in the spiritual unity of believers in our Lord Jesus Christ. I certify that the facts set forth in the application are true and cmplete to the best of my knowledge, and I authorize Crossroads Care Clinic to verify their accuracy and to obtain reference information on my work performance and character. Date * MM DD YYYY Signature of Applicant * Thank you for your submission!
