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• Country ARUBAAFGHANISTANANGOLAANGUILLAALBANIAANDORRANETHERLANDS ANTILLESUNITED ARAB EMIRATESARGENTINAARMENIAANTIGUA AND BARBUDAAUSTRALIAAUSTRIAAZERBAIJANBURUNDIBELGIUMBENINBURKINA FASOBANGLADESHBULGARIABAHRAINBAHAMASBOSNIA AND HERZEGOVINABELARUSBELIZEBERMUDABOLIVIABRAZILBARBADOSBRUNEI DARUSSALAMBHUTANBOTSWANACENTRAL AFRICAN REPUBLICCANADAREPUBLIC OF THE CONGOSWITZERLANDCHILECHINACOTE D'LVOIRECAMEROONDEMOCRATIC REPUBLIC OF THE CONGOREPUBLIC OF THE CONGOCOOK ISLANDSCOLOMBIACOMOROSCAPE VERDECOSTA RICACUBACAYMAN ISLANDSCYPRUSCZECH REPUBLICGERMANYDJIBOUTIDOMINICADENMARKDOMINICAN REPUBLICALGERIAECUADOREGYPTERITREASPAINESTONIAETHIOPIAEuropeFINLANDFIJIFALKLAND ISLANDSFOREIGNFRANCEFAROE ISLANDSFEDERATED STATES OF MICRONESIAFRENCH SOUTHERN TERRITORIESGABONGREAT BRITAINGEORGIAGHANAGIBRALTARGUINEAGUADELOUPEGAMBIAGUINEA-BISSAUEQUATORIAL GUINEAGREECEGRENADAGREENLANDGUATEMALAFRENCH GUIANAGUYANAHONG KONGHONDURASHollandCROATIAHAITIHUNGARYINDONESIAINDIAIRELANDIRANIRAQICELANDIsraelITALYJAMAICAJORDANJAPANKAZAKHSTANKENYAKYRGYZSTANCAMBODIAKIRIBATIREPUBLIC OF KOREAKUWAITLAOSLEBANONLIBERIALIBYASAINT LUCIALIECHTENSTEINSRI LANKALESOTHOLITHUANIALUXEMBOURGLATVIAMACAUMOROCCOMOLDOVAMADAGASCARMALDIVESMEXICOMACEDONIAMALIMALTAMONGOLIAMONACOMOZAMBIQUEMAURITANIAMONTSERRATMARTINIQUEMAURITIUSMALAWIMALAYSIANAMIBIANEW CALEDONIANEPALNIGERNIGERIANICARAGUANETHERLANDSNORWAYNAURUNEW ZEALANDOMANPAKISTANPANAMAPITCAIRN ISLANDPERUPHILIPPINESPALAUPAPUA NEW GUINEAPOLANDNORTH KOREAPORTUGALPARAGUAYFRENCH POLYNESIAQATARREUNIONROMANIARUSSIARWANDASAMOASAUDI ARABIASERBIA-MONTENEGROSUDANSENEGALSINGAPORESAINT HELENASAINT KITTS AND NEVISSOLOMON ISLANDSSIERRA LEONEEL SALVADORSAN MARINOSOMALIASAINT PIERRE AND MIQUELONSAO TOME AND PRINCIPESURINAMESLOVAKIASLOVENIASWEDENSWAZILANDSEYCHELLESSYRIATURKS AND CAICOS ISLANDSCHADTOGOTHAILANDTAJIKISTANTURKMENISTANEAST TIMORTONGATRINIDADTRINIDAD AND TOBAGOTUNISIATURKEYTUVALUTAIWANTANZANIAUGANDAUnited KingdomUKRAINEURUGUAYUnited StatesVATICAN CITYVENEZUELABRITISH VIRGIN ISLANDSST. VINCENT AND THE GRENADINESVIETNAMVANUATUWALLIS AND FUTUNA ISLANDSBURMAYEMENSOUTH AFRICAZAMBIAZIMBABWE
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• Primary Language Select English Spanish German Mandarin Cantonese Vietnames Korean Japanese

• How would you like to be contacted? Select Home Phone Cell Phone Email
• Languages (other than English) Select English Spanish German Mandarin Cantonese Vietnames Korean Japanese
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  What is the best time to be contacted? Select Morning Noon Evening
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  Gender Select Male Female
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  How did you hear about us? Select Hour of Power Powerlines Crystal Cathedral Today Internet/CC Website Attended Church Service Church Member Other
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  Age Select Under 18 18 - 25 26 - 50 51 - 75 76 +
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  If other, please explain

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  I am interested in volunteer opportunities that deal with: (check all that apply)
• Chinese orphans
• Physically-handicapped individuals
• Foster-parent programs
• Teaching English as a Second Language (ESL)
• Teaching music & visual arts to children
• Improving the quality of public education for migrant children
• Building water storage wells & providing safe drinking water to
         rural & drought stricken areas in China
• Energy and solar lighting technologies
• Medical missions
• Marital and Family Counseling
• Computer training
• Other:

• 
  Which demographic group are you most interested in helping?: (check all that apply)
• Adults
• Families
• Infants & Small Children
• Elementary School aged children
• Teen Aged Children
• Special Needs/Handicapped Individuals
• Other:

• 
  How much time and when are you interested and willing to commit to volunteering in this program?

• 
  Travel to China: (check all that apply)
• I am interested in learning more about travel opportunities
         and mission programs to China.
• I am able to travel to China.
• I am unable to travel to China, but would enjoy participating in
         some type of related project in my own community.

• 
  Are you currently Employed?
• Yes, my job title is
• No
• Retired

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  What are your other past occupations, if different from above?

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  Are you a student?Yes, my school is
• No

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  Highest education attained Select High School Some College College Post-graduate Work
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  Degree:
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  Professional Training & Licenses Select Medical Legal Engineering Nursing Physical/Occupational Therapy Education/Teaching Technological Other
  
  If other, please explain

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  Other Permits, or Certifications that I hold

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  Previous and Current Volunteer Experience (Community affiliations, organizations, nature of service, dates)

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  Is there any health reason that might limit your ability to volunteer?
• No
• Yes
• 
  If yes, please explain

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  Other Skills, Talents or Ways I can contribute to this Volunteer Experience

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