Volunteer Application Form

Name

Address

City

State

Zip Code

Home Phone

Email Address

What languages do you speak?

Emergency Contact (List Name/Phone Number/Relation to You)

Will anyone else be traveling with you when you visit the school? If so, please provide name(s).

What Church do you attend?

Are you a member of that church? Are you a member of that church?YesNo

Do you sponsor an IMA child? If so, please list their name(s).

I will refrain from using alcohol, drugs and/or tobacco while at the IMA school. I will refrain from using alcohol, drugs and/or tobacco while at the IMA school.YesNo

Have you ever been charged with a felony or child molestation? Have you ever been charged with a felony or child molestation?No, I have never been charged with a felony or child molestation.Yes, I have been charged with a felony or child molestation.