Contact Information

Name

Street Address

City ST ZIP Code

Home Phone

Work Phone

E-Mail Address

Date of birth

About you:  Please tell us about yourself, and how did you hear about CMF?

  ___ Sorting  Supplies

  ___ Events

  ___ Maintenance

  ___ Fundraising

  ___ Pick Up & Deliveries

  ___ Phone Bank

  ___ Bulk Mailings

  ___ Volunteer coordination

Person to Notify in Case of Emergency

Name

Street Address

City ST ZIP Code

Phone

Home:                    Cell:                          Work:            

E-Mail Address

Agreement and Signature

I affirm that the facts set forth in it are true and complete.

Name (printed)

Signature

Date

Our Policy

The volunteer hereby irrevocably and unconditionally agrees to release and hold harmless the Christian Medical Fellowship, its Administrative Coordinator, its Board of Directors, its Advisors and Consultants, and all others associated with the Christian Medical Fellowship, from any and all costs, expenses, liabilities, attorney’s fees, or any other damages, claims, or suits for damages, personal injury, wrongful death, or property loss/damage related in any way to volunteering at the CMF office or other outside facility.

Thank you for completing this application form and for your interest in volunteering with us.