APOPKA PREGNANCY CENTER VOUNTEER & BOARD MEMBER APPLICATION FORM
Circle Position of Interest:
Counselor Nurse Boutique Clerical Housekeeping
List the hours you can work during these hours that we are open
Mon. 5 – 7 pm Wed. 1- 7 pm
Fri. 1 – 7 pm
Mon: __________ Wed:
__________ Fri: __________
(day) Phone (evening)
City _______________________________________ Zip Code _______________
Date of Birth _____/_____/_______ Age_______
Circle: Married Single
If Married, spouse’s
1. 1. Special gifts, talents or personality
traits you can bring to this ministry?
2. Educational Background? List
any special training, Biblical Studies or educational experience.
3. Describe 5 things you have enjoyed doing most in your life
from age five until now. Describe what you did well and what made you enjoy doing it. Describe each experience
in a few sentences.
4. What are your areas of strength?
5. What are your areas of weakness?
6. What personality do you have difficulty working with?
7. How do you resolve conflict/disagreements?
1. What is your reason for getting involved in the APCC?
2. How did you hear about the Apopka Pregnancy Center?
3. What other ministries or organizations have you either
been a lay Counselor for or been involved?
4. How does your spouse/family feel about this involvement?
5. Have you ever counseled a woman who was considering an abortion?
6. Have you ever known a single mother?
7. Under what circumstances, if any, would you consider abortion as an alternative for women’s crisis pregnancy?
8. What is your knowledge of:
a) abortion risks?
____Good ____Fair _____ Poor
b) existing laws regulating abortions?
_____Fair ______ Poor
9. Please list any books, films or other materials that you
have read or viewed that relate to abortions.
10. How do you feel about a single woman parenting her baby?
11. How do you feel about a woman placing her baby for adoption?
12. Are you currently seeking to adopt a child? Yes No
When do you think
sexual intercourse is morally permissible?
14. What are your feelings regarding birth control and teenagers
or adults who are sexually active?
15. If selected as a counselor, will you consistently make a commitment each week to God's work through APCC?
Please list any further comments that might be helpful for the Director
to know you better.
1. Do you consider yourself a Christian?
a. please explain what it means to be a Christian:
How long have you been
a believer? __________
c. Please give a brief testimony about you came to believe
in Jesus Christ/ Messiah as your personal Lord and Savior.
d. How has your life changed since your personal relationship
with the Lord began?
e. What church do you attend? ___________________________________________________
Address_________________________________ City______________ State ________ ZC
Phone Number_____________________________ Pastor _________________________
Are you a member? Yes
f. How long have you been involved at your church?
g. Are you currently involved in a Bible Study?
If yes, how long? _____________
2. Do you have a daily devotional time?
If yes, briefly describe:
3. Volunteering at the APCC is spiritual warfare. How
do you feel you will personally handle this? Briefly describe?
Please list the names and addresses of
two other people we may contact for references:
Under the Lordship of Jesus Christ, the mission
of the Apopka Pregnancy Center is to support and care for those affected by an unplanned pregnancy. This will be accomplished
by helping families make life affirming choices through evangelism, instruction and mentoring.
Date Returned ______________________________
Date ___________________________ Interviewed by______________________________