Sav-a-Life Pregnancy Center
Last First Middle Initial
Number & street City State Zip code
Date of Birth:____________________
Have you ever been convicted of a crime? ___Yes ___No
If yes, explain:__________________________________________________________________________
High School: Number of years completed (circle one) 1 2 3 4 Diploma: ___Yes ___No
Previous Volunteer Experience: List most recent volunteer experience first.
Organization _____________________________ Date of volunteer service: From_________ To_________
Telephone __________________________ Supervisor name ____________________________________
Organization ____________________________ Date of volunteer service: From_________ To_________
Telephone _________________________ Supervisor name _____________________________________
1. What is your reason for seeking to volunteer here?________________________________________
2. Do you consider yourself a Christian? ___ Yes ___ No
If yes, how long have you been a Christian? _____________
3. As a Christian, what is the basis of your salvation? __________________________________________
4. Please provide the following information concerning your local church.
Church name _________________________________ Denomination_______________________
Pastor's name ______________________________________ Phone_________________________
Positions in which you have served ___________________________________________________
5. This organization is a Christian pro-life ministry. We believe that our faith in Jesus Christ empowers us, enables us, and motivates us to provide pregnancy services in this community. Please write a brief statement about how your faith would affect your volunteer work at this center.
6. What special skills, talents, gifts, or personality traits would you bring to this ministry?
7. Have you ever counseled a woman who was considering an abortion? ___ Yes ___ No
8. Have you had any traumatic experiences relating to abortion? ___ Yes ___ No
9. Have you ever known a single pregnant woman? ___ Yes ___ No
10. Under what circumstances would you consider abortion as an alternative for a woman with an unplanned pregnancy?
__________ Never an option
__________ In cases of rape or incest
__________ In cases where the mother's life was in extreme peril
___________ In cases of extreme psychological distress
___________ Other (specify) ____________________________________________________________
11. Please list any books, films, or other material that you have read or viewed that relate to abortion, pregnancy, or alternatives to abortion.
12. How would you rate yourself in the following areas?
a. Knowledge of abortion methods excellent___ good___ fair___ poor___
b. Knowledge of current laws concerning abortion excellent___ good___ fair___ poor___
c. Knowledge of what the Bible teaches about abortion excellent___ good___ fair___ poor___
13. Are you currently or have you ever been involved in seeking to adopt a child? ___ Yes ___ No
14. What do you consider to be your possible areas of weakness?
15. Are there any particular personality types with whom you have difficulty working?
Please list persons who are not related to you and who have known you for at least two years, including your pastor.
Name Address Phone # Years acquainted Relationship
APPLICANT'S CERTIFICATION AND AGREEMENT
I certify that the facts set forth in this volunteer application are true and complete to the best of my knowledge, and I authorize the pregnancy center to verify their accuracy and to obtain reference information concerning my character and capabilities. I release the pregnancy center and any person or entity providing such reference information from any and all liability relating to the provision of such information or relating to any decisions made based upon such information. I give permission to the center to conduct a criminal background check to the extent that my volunteer duties may involve direct interaction with minors. If I become a volunteer at the pregnancy center, I agree to fully adhere to its policies and rules, including those rules relating to maintaining client confidentiality. I recognize that, as a volunteer, I will serve in a different role than the employees of the pregnancy center, and I am not seeking, nor expecting to receive, any compensation or other benefits in return for any volunteer services which I may provide for this ministry.
I further certify that I have read and that I am in full agreement with the pregnancy center's Statement of Faith and Statement of Principle.
Signature of applicant___________________________________________________
Volunteer Acknowledgement and Pledge
I acknowledge that Sav-A-Life Pregnancy Center is a Christian ministry which requires that all volunteers subscribe to its Statement of Faith and Statement of Principle and which further requires that all volunteers uphold Christian morals and standards within their daily lives. Accordingly, I pledge as follows:
1. I have accepted Jesus Christ as my personal Savior and Lord.
2. I have read this Statement of Faith of Sav-A-Life Pregnancy Center, and I am in full agreement.
3. During the time I am a volunteer at Sav-A-Life, I agree to regularly attend a Christian church.
4. During the time I am employed with Sav-A-Life, I will consistently seek to live my life in a way that upholds Christian morals and standards.
5. Recognizing the commands of the Bible and the fact that this ministry is committed to proclaiming a message of sexual abstinence, I will, while a volunteer at Sav-A-Life, refrain from engaging in any sexual relationships outside the bonds of Christian marriage.
6. I believe in the sanctity of human life as taught in the Bible. Therefore, I reject abortion as an acceptable option for any woman facing an unplanned pregnancy, except to save the life of the mother in some cases (e.g. tubal pregnancy).
I also acknowledge that I have read, understand, and agree with Sav-A-Life's Statement of Principle and will at all times uphold it, as well as all policies and procedures established by the Board of Directors.
I accept the responsibility to act as an advocate on behalf of the women to whom I minister; to give accurate information, emotional support, and spiritual guidance. ALL INFORMATION CONCERNING CLIENTS WILL BE KEPT IN STRICTEST CONFIDENCE, INCLUDING AFTER I LEAVE MY EMPLOYMENT WITH SAV-A-LIFE.
Staff/Volunteer Signature Date
SAV-A-LIFE PREGNANCY CENTER STATEMENT OF FAITH
We believe the Bible to be the inspired, the only infallible, authoritative Word of God. We believe that there is one God, eternally existent in three persons: Father, Son and Holy Spirit. We believe in the deity of our Lord Jesus Christ, in His virgin birth, in His sinless life, in His miracles, in His vicarious and atoning death through his shed blood, in His bodily resurrection, in His ascension to the right hand of the Father, and in His personal return in power and glory. We believe that for the salvation of lost and sinful man, regeneration by the Holy Spirit is absolutely essential, and that salvation is received through faith in Jesus Christ as Savior and Lord, and not as a result of good works. We believe in the present ministry of the Holy Spirit by whose indwelling the Christian is enabled to live a godly life and to perform good works. We believe in the resurrection of both the saved and the lost; they that are saved unto resurrection of life and they that are lost unto the resurrection of damnation. We believe in the spiritual unity of believers in our Lord Jesus Christ.
STATEMENT OF PRINCIPLE
The pregnancy center is an outreach ministry of Jesus Christ through His church. Therefore, the pregnancy center, embodied in its volunteers, is committed to presenting the Gospel of our Lord to women with crisis pregnancies ñ both in word and in deed. Commensurate with this purpose, those who labor as pregnancy center board members, directors and volunteers are expected to know Christ as their Savior and Lord.
The pregnancy center is committed to providing clients with accurate and complete information about both prenatal development and abortion.
The pregnancy center is committed to integrity in dealing with clients, earning their trust and providing promised information and services. The pregnancy center denounces any form of deception in its corporate advertising or individual conversations with clients.
The pregnancy center is committed to assisting women to carry to term by providing emotional support and practical assistance. Through the provision of God's people and the community at large, women may face the future with hope, and plan constructively for themselves and their babies.
The pregnancy center does not discriminate in providing services because of race, creed, color national origin, age or marital status of its clients.
The pregnancy center does not recommend, provide, or refer for abortion or abortifacients.
The pregnancy center offers assistance free of charge at all times.
The pregnancy center is committed to creating awareness within the local community of the needs of pregnant women, and of the fact that abortion only compounds human need rather than resolving it.
The pregnancy center does not recommend, provide, or refer single women for contraceptives. (Married women seeking contraceptive information should be urged to seek counsel, along with their husbands, from their pastor or physician.)
The pregnancy center recognizes the validity of adoption as one alternative to abortion, but is not biased toward adoption when compared of other life-saving alternatives. Centers are independent of adoption agencies, relating to them in the same manner as to other helpful referral sources. Pregnancy centers receive no payment of any kind from these agencies, do not enter into contractual relationships with them, and do not share combined office space. Adoption agencies are not established under the auspices of centers. Pregnancy centers neither initiate nor facilitate independent adoptions, though they may refer for independent adoptions in states where it is legal.
Sav-A-Life Pregnancy Center Commitment of Care
Clients are served without regard to age, race, income, nationality, religious affiliation, disability or other arbitrary circumstances. Clients are treated with kindness, compassion and in a professional manner.
Clients always receive honest, open, current & applicable information on medical safety & risk on client specific questions, & community organizations assistance information during their appointment.
Client pregnancy tests and 1st trimester “limited” Ultrasound exams are performed, in accordance to Sav-A-Life’s Pregnancy Medical Policies & Procedures Manual, and administered in accordance with all applicable 501(c)3 Pregnancy Medical Centers’ (PMCs) laws.
Client information is held in strict and absolute confidence. Client information is only disclosed as required by law and when necessary to protect the client or others against imminent harm.
Clients receive accurate information about pregnancy, fetal development, lifestyle issues, and related concerns.
We do not offer, recommend or refer for abortions or abortifacients, but we are committed to offering accurate information about abortion procedures and risks.
All of our advertising and communications are truthful and honest and accurately describe the services we offer.
All of our staff and volunteers receive proper training to uphold these standards.
Sav-A-Life is a non-denominational Pro-Life gospel ministry that is dedicated to providing free physical, emotional, and spiritual counseling and help services to Morgan & Lawrence counties’ women experiencing an unplanned pregnancy related crisis, and enabling them to make an informed decision on which of the 3 unplanned pregnancy options (parenting, adoption, or abortion) is the best choice for their crisis situation.