Volunteer

Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Birth Date

MM

DD

YYYY

What is your area of interest? *

Senior Care

Correctional Care

Prayer Team

Church Liaison

Board Member

Event Committee

Adopt-a-Facility Program

Other (social media, music, video productions, publications, education/training, etc.)

Can you commit to a minimum of 6 months as a GSM volunteer?

Because the good news of Jesus is best shared in relationship, ideally GSM volunteers serve for a minimum of 6 months.

Yes

No

Signature *

I, the undersigned, understand that a background check will be a routine procedure as part of volunteering with GSM. By signing below, I give permission to GSM, and/or the care facility/jail to which I am assigned, to conduct the necessary background checks on me.

First Name

Last Name