Volunteer Application Volunteer Application Today's Date At which location are you interested in volunteering?*Merci's Refuge (Champaign, IL)Not sure/Other OptionBloomington, ILChampaign, ILFrankfort, INGrundy/S. Will Co. (Coal City), ILJacksonville, ILKankakee, ILKokomo, INLincoln, ILMontgomery Co. (Hillsboro), ILShelbyville, ILTazewell Co. (Pekin), ILWill Co. (Joliet), ILName* First Last Email (Do not use yahoo, ymail or aol.com email addresses. Please call)* PhoneAddress Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Date of Birth* Name of Church*Name, Phone and Email of Pastor*Name, Phone and Email of Reference #1*This person should be aware of your gifts and passions.Name, Phone and Email of Reference #2*This person should be aware of your gifts and passions.Date you committed your life to Christ If you are not sure of a specific date, please describe the general time frame in your testimony below.Please share your testimonyYou may write out your testimony in a different format at upload it below.Upload your testimony hereHave you read our Statements of Faith, Purpose and Principle?*YesNoIf you have not read these documents, please open a new tab or window and go to the homepage of our donor website www.hopeforafuture.com and then click on the "About Us" tab. Note: If you close or exit this page your information will be lost.Are you in agreement with these Statements?*YesI have some questions I would like to ask firstNoWhat are your strengths, talents, gifts and/or passions?*Please indicate any evangelism experience you have.*How did you hear about the PRC ministry?*Please describe your position on abortion?*What are the times you are available to be at the Pregnancy Resource Center?NameThis field is for validation purposes and should be left unchanged.