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Volunteer Application Form

Only complete this form if you've been asked to by one of the staff of Saint Barnabas in preparation for serving as a volunteer. Thank you!

  • MM slash DD slash YYYY
  • AddressCityStateZip 
  • Please list two references who can speak to your abilities and character. Only one may be a Saint Barnabas parishioner.
    NameHow Long You've Known this PersonPhoneEmailRelationship to You 
  • Please enter at least 4 examples of volunteer experience.
    OrganizationContact PersonDutiesDates you Served 
  • Please give an example of a 'boundary violation.' Has that ever happened to you, or has anyone ever said that you violated a boundary of some sort?
  • Have you ever been asked to resign or been terminated by a training program/volunteer position/employer? If yes, please explain. If no, type no.
  • Have you ever been charged (formally or informally) with any ethics violations, sexual exploitation, sexual abuse or sexual harassment? Are any such actions or complaints pending against you?If yes, please explain. If no, type no.
  • Are you now or have you ever had sexual contact or attempted sexual contact (sexual intercourse of any kind, intentional touching, or conversation for the purpose of sexual arousal) with any person you were/are seeing in any professional context or in a Pastoral Relationship (ie: parishioner, client, patient, employee, student)? If yes, please explain. If no, type no.
  • Are you now or have you ever been involved in the production, sale, or distribution of pornographic materials? If yes, please explain. If no, type no.
  • Have you ever had disciplinary actions by a professional board or association or a restraining order, injunction, order for protection or the like ever issued against you? Have you ever had parental rights restricted, suspended, or terminated, or have your children ever been in foster care? Have you ever been accused of domestic violence? If yes, please explain. If no, type no.