Parish Pastoral Visitor to the Sick and the Homebound



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	Updated on Mar. 5, 2003 Comments on this website?

Christian Service

Last Name	First Name	MI
Street Address
City	State	Zip Code
Telephone # (Home)	(Work)	(E-mail)
Emergency Contact Name and Number?
Do you speak any language other than English?
Please explain your reasons for volunteering in this Ministry?


What are your expectations about participating in this Ministry?

What uncertainties or hesitations do you have about volunteering for this Ministry?

What previous experiences have you had, or, what skills do you now have which might contribute to your work in this Ministry?


When (days/times) would you be available to serve in this Ministry?
Are you willing to participate in spiritual growth and continuing education opportunities available in this Ministry?
Are you willing to participate in off-site training for this Ministry? Yes , No
Do you have any particular preferences related to the type of training you would like to receive?


What are your Visitation Preferences? Homebound Nursing Center / Rehab Unit /Assisted Living / Housing Authority (Duncklee/Parker Chase) Male Female Disabled