CPC Women's Health Resource | Volunteer & Employment Application

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Your Personal Information

Your Name(Required)

First Last

Address(Required)

Street Address Mailing Address City State / Province / Region ZIP / Postal Code

Your Email Address(Required)

Enter Email Confirm Email

Your Phone(Required)

Best Time To Call You

When is the best time for us to reach you via telephone?

Occupation

Previous Occupations

Previous Volunteer Experience

Emergency Contact:(Required)

Name and Phone Number

1. Do you consider yourself a Christian?

Yes

What is a Christian?

2. When did you become a Christian?

Please share the circumstances that led you to become a believer.

3. Share the areas of Christian growth and maturity that have resulted since your conversion.

4. Please provide the following information on your local church:

Church Name

Church Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Church Info

Pastor's Name

Phone

Protestant or Catholic?

Describe the positions held/services performed within the church.

May we call your pastor for a reference?

5. Please provide the following information about yourself:

What is the extent of your formal education?

Areas of concentration:

List any special training, Biblical studies, or educational experiences:

6. State briefly why you are interested in serving at the CPC:

7. How does your spouse/family feel about you working for a pro-life organization?

8. What special gifts, talents or personality traits do you bring to this ministry?

9. Have you ever counseled a woman who was considering an abortion?

Explain

10. Have you ever had any traumatic experiences related to abortion?

Explain

11. What is your view on single or unwed mothers?

12. Under what circumstances would you consider abortion as an alternative for a woman with a crisis pregnancy?

In cases of rape and incest

In cases of severe psychological distress

Never an option

Other

Personal Abortion Knowledge: In this section, please make a general evaluation of your knowledge in the following areas:

a. Knowledge of how abortion are performed/methods used to perform abortions:

Extremely Knowledgeable: You have a high level of understanding about the topic.

Somewhat Knowledgeable: You have a high level of understanding about the topic but there is more to learn.

Developing: You are beginning to learn beyond the basics about the topic.

Somewhat Novice: You have a basic understanding of the topic.

Novice: You have no understanding of the topic.

b. Knowledge of existing laws regulating abortion:

Extremely Knowledgeable: You have a high level of understanding about the topic.

Somewhat Knowledgeable: You have a high level of understanding about the topic but there is more to learn.

Developing: You are beginning to learn beyond the basics about the topic.

Somewhat Novice: You have a basic understanding of the topic.

Novice: You have no understanding of the topic.

c. Knowledge of what the Bible teaches (directly or indirectly) about abortion:

Extremely Knowledgeable: You have a high level of understanding about the topic.

Somewhat Knowledgeable: You have a high level of understanding about the topic but there is more to learn.

Developing: You are beginning to learn beyond the basics about the topic.

Somewhat Novice: You have a basic understanding of the topic.

Novice: You have no understanding of the topic.

Please list any books, films, videos, or materials that you have read or viewed that relate to abortion, pregnancy, or any alternatives to abortion:

Rate your comfort level in communicating adoption as a lifesaving alternative to abortion:

Very Comfortable

Somewhat Comfortable

Neutral

Somewhat Uncomfortable

Very Uncomfortable

Position You Are Applying For

Volunteer Position You Are Applying For

Client Advocate

Spanish Client Advocate

Material Assistance

Receptionist/Secretary

Church Ambassador Program

Community Outreach/Fundraising

Grant Writing

IT/Technical

Facilities Maintenance

Housekeeping

Which location are you applying to serve at?

Bryan Clinic

Hours: Wednesday 9:30am-4:00pm; Friday 9:30am-5:00pm

Defiance Clinic

Hours: Tuesday 9:30am-5:30pm; Thursday 9:30am-5:30pm

Napoleon Clinic

Hours: Monday 9:30am-5:30pm; Wednesday 9:30am-5:30pm

Wauseon Clinic

Hours: Tuesday 9:30am-5:30pm; Thursday 9:30am-5:30pm

Hours You Are Available

Please tell us what hours you are available to volunteer each day of the week.

Monday

Tuesday

Wednesday

Thursday

Friday

Weekend Hours You Are Available to Volunteer

Opportunities sometimes arise to attend community events and share about the CPC at our supporting churches. Please tell us what weekend hours you are available to volunteer.

Saturday

Sunday – Church Presentations Only

More About You

Tell Us About Yourself

What other information do you want us to know about you?