201 VOLUNTEER

REGISTRATION FORM
NAME 2x2
Surname Given Name M.I.

ADDRESS

DATE OF BIRTH: __/__/__ AGE: GENDER:

CELLPHONE NO.: CIVIL STATUS:
OTHER NUMBERS: OCCUPATION:
SPOUSE’s NAME: LANGUAGE/S:
SPOUSE’s NO.: EMAIL ADD. :
In Case of Emergency CONTACT PERSON:
PAST MEDICAL ILLNESS:
In Case of Emergency CONTACT NUMBER:

EDUCATIONAL ATTAINMENT: COURSE:

Please answer the following questions.

1. Have you attended trainings related to rescue or

leadership training? If yes, please enumerate.
2. What are your skills? (Ex. Driving)
3. How did you discover the News & Rescue Membership? Local Announcement Referral Others:_______________
4. Are you willing to be a rescue volunteer? YES NO
YES NO
5. Are your ready to allot your available time to duty as a
If YES, what day/s of the week works best for your schedule?
responder?
(Pls. indicate)__________________________________________________
6. Are you committed to undergo continuous trainings? YES NO
STATEMENT
I hereby certify that the above information is true and correct.
___________________________________ ________________
SIGNATURE OVER PRINTED NAME DATE
Ver.2.0.0 FEB 18’
SCREENING
SCREENING REMARKS: Screened by: ___________________________
(This section is to be filled up by a facilitator.) (Signature over printed name)

VOLUNTEER RECOMMENDATION SLIP

NAME: LOCALE: DIST: DIV.:
DATE OF BAPTISM: ___ /___ /____ AGE IN SPIRIT: BAPTIZER:
We hereby recommend the applicant that he/she is an active MCGI member & capable to be a rescue volunteer.
__________________________ _____________________________
LOCALE DEACON/ DEACONESS ASSIGNED WORKER
___________________________________ ___________________________________
DIST. COORDINATOR / DIST. SERVANT KATULONG NG PANGANGASIWA