Life Support Application

ABOUT US SERVICES WE OFFER NEWS & EVENTS EMPLOYMENT RESOURCES OUR DONORS VOLUNTEERS Volunteer Orientation Volunteer Applications Client Care Application Life Support Application Client Care Training Program Volunteer Staff Meetings Visions Newsletter MATERIAL AID CONTACT US HOME


The following chart is a window into our history.
	1981	2007
People Served	3,109	16,333
Volunteers	10	335
Offices	1	5

Life Support Volunteer Application

Please complete this application only after viewing our Volunteer Orientation.

* denotes required field

Have you viewed the Volunteer Orientation? Yes No

Name: *

Address: *

City: *

Zip: *

Home phone: *

Cell phone:

Work phone:

Email address: *

Date of birth (without year): *

Are you 21 years of age or older? * Yes No

Name of local church: *

Languages spoken (other than English):

Please check the opportunities you are most interested in:

Administrative (Administration Office only)

Mailings
Data Entry
Clerical

Development and Special Events (Administration Office/Special Events sites only)

Walk and Run for Life
Golf for Life
Fund Raising Banquets
Assist at Special Events
Baby Bottle Campaign
Church Liason

Maintenance (Various locations)

Gardening and yard work
Cleaning
Painting
General repair
Deliveries

Prayer Team (From home - must have access to email)

Pray for clients vulnerable to abortion

Please list other skills that you wish to utilize as a PDHC volunteer:

When are you available to volunteer (e.g., day of the week, daytime/evening, etc.)?

Would you like to come in on a regular schedule, or be contacted as needed?

Regular schedule
As needed

Submit Form