Knox Church -HandiWorks Volunteer Application

HandiWorks Volunteer Application

First name: *

Last name: *

Cell phone number:

Alternate phone number:

Alternate phone type:

Home Phone

Office Phone

Address: *

Country

City

Zip code

Email: *

Name of emergency contact:

Emergency contact's phone number:

Emergency contact's alternate phone number:

Member of Knox Presbyterian Church of Ann Arbor? *

Yes

If yes, for how long?

Reference: *

Please provide the name of one non-related person who could give an accurate assessment of your character and capabilities.

Reference's email address *

What handyman skills would you bring to this ministry? *

Plumbing

Electrical

Carpentry

Other

Please describe:

Are you licensed in any trades?

Yes

Please describe:

Are you covered by personal medical insurance?

Yes

If yes, name of insurer:

Policy or Group number:

Relationship to primary insured party:

NOTE: The church carries insurance that covers any expenses for injuries incurred while volunteering that would be covered on an excess basis after the individual’s health insurance responds. There is also liability protection if a volunteer causes damage to someone’s property or incorrectly fixes/installs something that causes damage later.

Applicant Agreement

I certify that the information I have provided in this application is correct to the best of my knowledge. I understand that this application will be kept strictly confidential.

Signature:

Sign using your keyboard mouse or finger.

Reset Signature

Date: *

Instructions

Please complete the application process:

After submitting this online application you will be automatically redirected to the Knox Applicant Release and Agreement Form. Please print and complete.
Submit to the Knox Office Manager in a sealed envelope.

Thank you for your interest in the Knox HandiWorks Team!

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HandiWorks Volunteer Application

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