Hit The Streets Volunteer Application

Name: ____________________________________

Street: ____________________________________ City: _________________________

Province: ____________ Postal Code:___________

Phone: ( )________________

Email: _________________________

Church Name: _____________________________ Church City: ___________________

Have you ever done street ministry of any kind before? Yes No (Circle One)

• If Yes tell us about it?

• If No, tell us why you are interested?

Please List Any Volunteer Experience.

Please List One Reference

Name:________________________

Relationship:___________________ How Long have you known them? ____________

Phone: ____________________

or

Email:_____________________

Any Questions or Comments?

I accept the values of Hit The Streets and to observe the policies and procedures including record keeping and confidentiality of client information.

Signed :_______________________________ Dated:__________________________

Please Mail to

Hit The Streets – Corey Hughes

Box 1101 Peterborough, ON

K9J 7H4