Grace Bible Center Community Service
                                          GRACE BIBLE CENTER                
            
         COMMUNITY SERVICE DISCLAIMER

The Community Service Program is available to residents of
the Northern Counties in Illinois only!     
    

Disclaimer: We are a non-profit organization, in the form of a church; filled with born again   
believers to do the will of God.  We are not affiliated with any governmental agencies; we do
not receive or provide any funds from other agencies.  We will work with the requesting agency and the
participant to assist in obtaining the necessary hours, requirements from the requesting party.

The hours that you perform community service are documented and reported to the requesting agency,
whether completed or incomplete by the date required by the agency.  
You must complete at
least 75% of the hours required with Grace Bible Center before Grace Bible Center will send a letter to the
requesting agency.

It is your responsibility to get to and from our location.  We cannot provide transportation or funds to
serve the community service duties.

If you are a minor requesting community service hours, it is necessary for the parent(s), and/or guardian of
the minor child to complete documentation that acknowledges and consents the participation
of your child.

Once you are accepted to participate in serving the community service hours here at Grace Bible Center,
you are expected to adhere to the time schedule agreed upon.  If for any reason you are unable to attend
at the time scheduled, it is your responsibility to inform us.  Failure to adhere to these terms will forfeit our
agreement to work with you and the requesting agency will be informed of your discontinuation of

community service through Grace Bible Center.

                                   APPOINTMENTS ARE NECESSARY!  
I do hereby agree, understand and accept these terms and conditions set forth in the above      
disclaimer.  I also hereby certify that I am over 18 years of age.    
            
                                            
                                           
INSTRUCTIONS TO APPLY!!!
                             

                                  ENTER YOUR NAME AND NUMBER BELOW              
                          
                                  
                   
                                                                                                      



                                           
 FINALLY MAKE YOUR CHOICE BELOW                


          
                            





________________________________                       __________________________________
Signature                                        Date                        Signature                                             Date
                                     

                                                   
YOUR NAME
TELEPHONE NO.
YOU WILL NEED TO PRINT OUT THIS
PAGE AND BRING IT WITH YOU
ONCE ACCEPTED.  WE SUGGEST
YOU PRINT THIS PAGE NOW!
I DO HEREBY ACCEPT
THESE TERMS
I DO NOT ACCEPT
THESE TERMS