Indicate form(s) of service with which you are willing to assist:
Construction/Maintenance Disaster relief Engineering/Design Property investigation/Evaluation
1. (a) Legal name: ___________________________________________________________ (b) Gender:
(Last) (First) (Middle)
2. Mailing address: _______________________________________________________________________________________
(Street address or route and box) (City) (Province or state) (Zone or code) (Country)
3. (a) Home telephone:_______________ (b) Mobile telephone: ______________ (c) E-mail address: _________________
4. (a) Date of birth: _____/_____/_____ (b) Date of baptism: _____/_____/_____ (c) LDC volunteer number: ______________
(Month) (Day) (Year) (Month) (Day) (Year) (if previously assigned)
5. Current privileges: Elder Ministerial servant Regular pioneer Special pioneer Other: ___________
6. How is your (a) physical health? Excellent Good Fair (b) emotional health? Excellent Good Fair
7. If married, name of mate: _______________________________________
8. (a) Do you have any children living at home? Yes No (b) If so, how old are they? __________________
9. Work background: As shown in the sample below, please list your skills in the order you feel you are most proficient. If li-
censed, give the license number and the province or state. Please check this box if you have attached a letter or a résumé.
Skill/Sub-Skill Specialties
Years of
Years of
Additional Notes
Cabinetry-Countertop Fabrication
Helped build custom kitchens for private homes.
I agree to cooperate fully with those overseeing the work and to work diligently under their direction to care for assigned tasks.
(Ps. 133:1; Isa. 6:8) At all times, I will conduct myself in harmony with Christian principles and adhere to established safety standards,
such as attending safety training sessions and using personal protective equipment. I understand that if I do not complete the application
in its entirety, the elders may not be able to determine whether I qualify for this privilege of service. I have agreed to provide this applica-
tion and the information herein to assist the body of elders in my local congregation to evaluate my qualifications for a privilege of ser-
vice. I expressly consent to their collection and processing of my personal data. I further consent to the local branch office of Jehovah’s
Witnesses or any of its representatives processing and retaining for its use the information on this application.
Signed by: /s/ _____________________________________________________________ ______________
(Type name to indicate signature) (Date)
Signed by: /s/ _____________________________________________________________ ______________
(Parent or guardianType name to indicate signature if the applicant is under 18 years of age) (Date)
Please review all the answers that the applicant has provided and consult with the appropriate group overseer to con-
sider if the volunteer is exemplary and of good spiritual, moral, and emotional health, does not have a serious health condi-
tion, and is cooperative with the body of elders. Those who view material inappropriate for Christians, such as pornogra-
phy, do not qualify. The applicant must not have been reproved or reinstated within the past year, and all restrictions must
have been lifted. Do not forward this application to the branch office if the applicant does not qualify. Discuss any reserva-
tions with the individual, and work with him to help him qualify in the future. If you approve this volunteer, please
promptly send the application to the Local Design/Construction Department at the branch office, if possible, by means of
the jw.org Inbox feature. Keep a copy of the completed application in the congregation file. If you wish to provide supple-
mental comments, please do so in a separate letter.
(Coordinator of the body of elders)
(Service overseer)
Congregation: _________________________________________________________________
(Province or state)
This application is for exemplary baptized publishers 13 years of age and older who are willing to assist periodically with construction or maintenance
projects for limited periods of time within a reasonable travel distance from their home. Only
those in good spiritual, physical, moral, and emotional
health should apply. All should have the spirit of the prophet Isaiah, who said: “Here I am! Send me!” (Isa. 6:8) While the greatest need is for those
who are skilled in construction, project development, and design, even those who do not have extensive experience in a construction-related trade
may apply. Volunteers between 1
3 and 15 years of age are permitted to work in nonconstruction areas only if they are accompanied by a parent or a
guardian. Volunteers 16 and 17 years of age are permitted to work in construction areas only if they are properly supervised. Please answer complete-
ly all questions applicable to you.
It is preferred that the information on this application be entered electronically. Applications should be renewed
every three years or when there is a change of circumstances that would affect the answers on this application.
DC-50-E 10/14