Homebound Ministry/Saint Raphael Catholic Church/Raleigh, NC

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You're invited to apply to be Saint Raphael's Homebound Ministry, to do the work of the Gospel using your skills, talents, and spirit.
First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.
Email REQUIRED Please fill out this field. Please enter an email address.
Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
Home address REQUIRED Please fill out this field. Please enter valid data.
City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.
I speak (at a conversational level) the following languages (choose all that apply) REQUIRED English Spanish Other Please fill out this field.
I will keep all information shared with me confidential.
I Agree Please select this field.
For the purposes of this agreement, “Confidential Information” shall mean member’s and non member’s personal information provided for the purpose of administering volunteer assistance to parishioners/members of Saint Raphael Catholic Parish. This information includes, but is not limited to names, addresses, telephone numbers, family members, and financial information. I agree to receive and maintain the Confidential Information in confidence by not reproducing the Confidential Information or any part there of without the express written consent of Saint Raphael the Archangel Catholic Parish. I will not, directly or indirectly, make known, divulge, publish or communicate the Confidential Information to any person, firm or corporation without the express written consent of Saint Raphael the Archangel Catholic Parish. I will utilize the best efforts possible to protect and safeguard the Confidential Information from loss, theft, destruction, or the like. I will limit my use of this information to the purpose of administering volunteer assistance to parishioners/members of the Saint Raphael community.
I Agree Please select this field.
Choose one: REQUIRED I will be working as an adult (18 years old or older) individual We will be working as a family team of adults and children. Please fill out this field.
Please note that, responsibilities can be delegated within the family to particular members based on their skill set. However, the adult who is filling out this form is the responsible adult who will be supervising anyone in your family who is helping, especially minors. Your top priorities should be appropriate confidentiality and safety for all parties involved.
I Understand and Agree Please select this field.
I will not give medical advice or provide medical assistance of any sort. In the case of an emergency. I will call 911 or direct someone else to call 911.
I Agree Please select this field.
I understand that I should not provide transportation for anyone while volunteering with the Saint Raphael homebound ministry team.
I Agree Please select this field.
Do you have any questions, comments, or concerns?
Is there anything else we should know about your limitations that may affect your ability or availability to volunteer?

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St. Raphael the Archangel

Raleigh, NC

Homebound Ministry

I want to help!

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