Volunteer Application Form

Thank you for your interest in volunteering at Lily of the Valley.

Please fill in the details below and we will get back to you as soon as we can. If you are unable to fill out an online form, you can download this application form in .doc format and post it to us at the address on our contact page.

Fields marked with a * are mandatory fields.

Personal Details

First Name*

Last Name*

Address*

Home Phone*

Cell Phone

Work Phone

Email Address* Date of Birth* Marital Status* Identity / Social Security Number (for background check)*

Proposed Dates of Stay at Lily of the Valley in South Africa

From:*

To:*

Personal History

Please list all schools that you have attended beginning with High School.

Name

City

Years

Degree/Certificate

Please provide the details of any specialized education or courses that may be particularly helpful to your volunteer work at Lily of the Valley

Please list your employment history for the past ten years

Company

City

Position

Dates Employed

Have you been convicted of a criminal offense (felony or serious misdemeanor)? If yes, state the nature of the crime, when and where convicted, and disposition of the case Have you ever been on a mission trip? If yes, please provide details Do you regularly attend a Church? YesNo

Please provide details for this Church

Name

City

Years attended

Have you ever been hospitalized? If yes, please provide details Are you currently dealing with any significant health issues? If yes, please provide details Describe what hobbies and skills you possess that would be beneficial as a volunteer at Lily of the Valley* Please explain in detail how you will arrange support for your financial needs while you are at Lily of the Valley* Please explain in detail why you are interested in volunteering at Lily of the Valley*

Please list below three persons not related to you who have knowledge of your skills, ability and character. Referees must be people of standing in the community (eg. a doctor, minister etc)

Name*

Relationship*

Email Address*

Phone Number*

Please provide at least 2-3 references from your referees* I agree to the conditions below

I hereby authorize LoV to thoroughly investigate my references, criminal record and other matters related to my suitability for volunteering with LoV. In addition, I hereby release LoV and all other persons, corporations, partnerships and associations from any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosure. I confirm that to the best of my knowledge, the information provided in this application form is true and correct. I agree to comply with any rules, regulations and instructions established by Lily of the Valley (LoV South Africa) and/or Lily of the Valley Endeavor (LoVE) USA; and I understand that failure to comply may result in immediate termination of my volunteer opportunity. I understand that I am responsible for raising financial support for the period of time that I will be volunteering at Lily of the Valley and that I will not be allowed to leave for South Africa until such time that I have either raised all of the money or have pledges committed for the entire period of time that I will function as a volunteer.

Volunteer Application Form

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