Sun Sat Fri Thur Wed Tues Mon Evening Afternoon Name: YesNo YesNo Do you have friends or relatives volunteering for Prison Fellowship?Are you currently on any prisoner's visiting list?YesNoProbation:YesNoOn Parole:YesNo (MM/DD/YYYY)Release Date:If yes, for what offense?WilberforceVictims MinistryUncertainTrainingRecognition and EvaluationPen Pal MinistryPrayer MinistryJob PlacementPerforming ArtsOperation Starting LineOffice/AdministrationMentoringMusicalLeadershipJusticeIn Prison MinistryIFIGeneral/OtherFamilyCommunity ServiceChurch/Volunteer RecruitmentChurchBreakpointAngel TreeAmbassadorAftercareVolunteer Application FormZip Code:Gender: M F State:Last Name: E-mail:Phone:State:City:Zip Code:Church City:Address:Church Denomination:Church Name:Pastor:Church Phone:Church Address:First Name: 

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Date of Birth:(MM/DD/YYYY)Marital Status: Single Married Widow/Widower Divorced Highest Education attained: Primary Language:I have read the

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Prison Fellowship Statement of Faithand it accurately reflects my personal beliefs.

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English Spanish 8th or Less 9th through 11th Associates Degree Bachelor's Degree Some College/Trade School Doctorate Degree GED Graduate Studies High School Diploma Master's Degree No Formal Education Post Graduate Studies Religious Studies/Degree We do not sell or share your personal information.

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I'm interested in...Administrative Support(children and youth) Mr. Mrs. Ms. Dr. Reverend Pastor If going into prison, please provide the following information: Have you ever been convicted of a crime? YesNo

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Previous or current volunteer participation: How did you learn about PFM's volunteer program? Select One AngelTree Radio Angel Tree TV Breakpoint Email Breakpoint Radio Church Presentation Event Ex-Inmate Literature Local Newspaper Past Involvement Website Purpose Driven Life Local Radio Referred by Staff Referred by Volunteer Word of Mouth Other: Do you have friends or relatives working for Prison Fellowship? Name:

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Please indicate the days and hours available to volunteer: Anytime Morning How much notice do you need prior to volunteering? Other pertinent information: