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Your name:
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Address, City, ST, Zip:
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Your phone number:
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Your email address:
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AVAILABILITY:
Grace Bible Center hours of Community Service are as follows:
Sunday 9:00 am - 2:30 pm
Wednesday 4:00 pm - 9:00 pm - Presently filled
Friday 4:00 pm - 9:00 pm - Presently filled
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What agency is requesting the
Community Service
assignment?
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Explain the reason why
community service is required?
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How many hours are required?
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Hours are required by
date?
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Comments:
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AGREEMENT AND SIGNATURE
By submitting this application, I affirm that the facts set forth above are true and complete. I
understand that as a community service volunteer, any false statements, omissions, or other
misrepresentations made by me on this registration may result in my immediate dismissal.
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Name printed:
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Signature:
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Date:
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OUR POLICY
It is the policy of this organization to provide equal opportunities without regard to race, color,
religion, national origin, gender, sexual preference, age or disability.
Thank you for your interest in doing Community Service with us.
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