First Name: *

 
Last Name: *

 
Phone #:

 
Street Address:

 
City:

 
State:

 
Zip Code:

 
I will be the prayer partner for this mentor: *

 
Please list previous volunteer activities:

 
*For promotional purposes, videos and photographs may be taken during Kids Hope events.  Occasionally, a photo of you may be shared with the KHUSA National Office to appear in the volunteer newsletter called Voices of Hope.  Your application and digital signature also constitutes permission for your email address to be added to the distribution lists for Voices of Hope and Story of the Week.*


Prayer Partner Pledge:
If I am assigned as a Prayer Partner, I accept the responsibility to serve in support of the educational program and honor the separation of church and state boundaries.  I understand that it is important to be reliable, channel suggestions constructively, keep information confidential, and comply with school rules.  As a memory or regular attendee of this church, I agree to be accountable to the leadership of this church regarding my Christian life and witness according to the biblical teaching of this church and in all aspects of conduct and performance related to this volunteer position.

 
Digital Signature of Applicant (please type your name to verify your Prayer Partner Pledge):

 
Date:

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