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UGM

Renewal Project

5119 River Rd. N

The Renewal Project at Simonka Place has begun!  Throughout the year we will be needing extra hands from our community to make it happen.

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First Name *
Middle Name
Last Name *
Mobile Phone *

For example, 123-456-7890
Mailing Address *
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Birthday *

A valid date as MM/DD/YYYY (for example: 11/30/2015)
Are you 18 years of age or older?
Are you at least 12 years of age?
Parent/Guardian First and Last Name
Parent/Guardian Phone
Parent/Guardian Email Address
Parent/Guardian Address
Unfortunately we do not allow children under the age of 12 to serve with us. Please come back to apply when you are of age.
Why are you interested in volunteering at Union Gospel Mission?
Are you volunteering as part of a requirement for School or Community Service?
How many hours do you need to complete?
Date due for hours requirement

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Were you referred? If so which organization?
Charge(s) Please include the charge in which you are doing the Community Service for
Are you currently employed?

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Location of Interest





What areas at the Men's Mission interest you?





What areas at Simonka Place interest you?






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Do you have other ideas of what you would like to do as a volunteer?
Emergency Contact First and Last Name *
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