Program Leader Application Form

If you feel called to bring sidewalk advocacy to your local community through Sidewalk Advocates for Life, please fill out this application to get started!

Please note: This entire form must be completed and the application fee paid in order to submit your application. (See Application Fee section below for additional information).

Personal Information

Your Name

Your Email

Your Cell Phone

Yes, it's okay to send me text messages including confirmations, changes, updates, and/or promotions. Message frequency varies. Message and data rates may apply. View our terms of service & privacy policy.

Your Home Phone

Your Work Phone Number

Your Address

If you live outside the United States, please provide your Skype Username here

Application Questions

Please answer yes or no to the following questions:

Do you believe in the sanctity of human life from conception to natural death?

Do you pledge that you are at least 18 years of age?

Have you ever been convicted of a crime (misdemeanor or felony)?

If yes, please explain:

Have you ever been subject to a restraining order or legal injunction of any kind?

If yes, please explain:

Have you participated in law-breaking activity involving an abortion or abortion-referral facility, including trespassing on abortion-facility property?

If yes, please explain:

Do you pledge that you are not connected to Planned Parenthood or the abortion industry as a donor, supporter, employee, or any other way?

If approved, do you pledge to conduct yourself and your program in a peaceful, prayerful, law-abiding manner — both in word and action — in accord with Sidewalk Advocates for Life's training and guidelines?

If approved, do you pledge to hold your first training within the next three months after receiving your official approval email?

Do you pledge to not add or subtract from our training materials, so that we can maintain the integrity of the program?

Do you pledge to keep your volunteer capacity with Sidewalk Advocates for Life completely separate from... (1) any campaign for/against a political candidate for office OR (2) any local, state, or national legislative initiative?

Do you agree to a criminal background screening as part of the standard approval process for leadership?

Before your application is approved, do you welcome a brief phone interview with our National Team so we can get to know you better?

Please review Sidewalk Advocates for Life Statement of Faith available here in full, and after reading --

Please affirm the following:

I have read the Sidewalk Advocates for Life Statement of Faith, and I understand that it reflects the core beliefs and values of Sidewalk Advocates for Life, where I currently serve as or am applying to be a Program Leader. I agree that when acting in my role as a Sidewalk Advocate, my words and actions will be consistent with this Statement of Faith.

I have read and agree to the terms above.

Public Information

Please list your preferred PUBLIC contact information (to be listed on the SAFL website once approved)

First Name Only

Cell Phone

Additional Information

If you are employed by/directly affiliated with a pregnancy help organization, please identify which one:

If you answered "other" to the question above, please list the pregnancy help organization with which you are affiliated or directly employed:

Please list any other pro-life organizations/ministries you're involved/associated with.

Please describe any prior leadership experience you have, including the name of the organization with which you gained this experience.

References

Please list 3 references (not related to you) whom we can contact. At least one reference from your local pro-life community is preferred.

Reference 1:

Name

City and State / Province / Territory

Relationship

Phone Number

Reference 2:

Name

City and State / Province / Territory

Relationship

Phone Number

Reference 3:

Name

City and State / Province / Territory

Relationship

Phone Number

Community Information

Name of the abortion or abortion-referral facility or other location where you will be conducting outreach:

Street Address of the outreach location

Please enter the name(s) of all the proposed Program Leaders for your team (i.e., you and any co-leaders who will be leading your Sidewalk Advocacy program for your local community).

The persons named above as Program Leaders should plan to join us on the brief phone interview with the National Team previously mentioned.

Application Fee

Payment of the application fee is required before submitting this Application. This fee covers your "starter package" and grants you access to all other training, tools, and support in the program once your Application is approved. Please complete the billing information below and click "submit" to complete your Application.

If you wish to pay the application fee by check or you have any other questions or concerns about the fee or this application, please contact [email protected].

Application Fee

$197.00

Coupon Code

Subtotal

$197.00

Total

$197.00

IMPORTANT

Applications to lead a sidewalk advocacy program to your community will be reviewed by the Sidewalk Advocates for Life National Team.

Once we've had a chance to review your application, we will contact you to set up a brief conference call to get to know you and your community better and answer preliminary questions.

Once preliminarily approved, we will request your permission to complete a criminal background screening through PeopleTrail. After the background screening is completed and approved, we will send you notice of your final approval via email with a link to the SAFL Pledge of Integrity to sign. Once we receive your signed Pledge, we will ship you the "starter package"; you'll then be authorized to begin setting up the program in your community. If your application is not approved, you will be refunded the application fee.

You may begin setting up the program under SAFL after you have received confirmation of approval from the National Team and paid the $197 application fee. After running the program for 6 months, you have the option to renew your program with us.

Please note that the billing information below is for a new application fee only. To renew an existing location, please go to sidewalkadvocates.org/renewal. If you would like to make a donation to Sidewalk Advocates for Life, please visit sidewalkadvocates.org/donate.

Billing Information

Name

Credit Card

Visa
Mastercard
American Express
Discover

Address

Mobile Phone Number