DVSAS | How to Volunteer | Volunteer Application

Applicant Information

* Required Fields

Name: * Email: Address: Address2: City: State: Zip: Home phone: Work phone: Cell phone: Best time to call: Birth date:

Interest in DVSAS

How did you hear about volunteering at DVSAS: Website Which one: Newspaper Which one: Poster Poster location: Friend Who: Other Please specify: How many hours each week do you have available for volunteering: What volunteer positions/program are you interested in: On call advocacy (24 hour pager) Childrens group advocate Hotline / walk-in services (in-office) Criminal Justice Advocacy Program Undecided Do you have any friends or relatives that are present or past volunteers or staff members: Yes No If yes, their name & approximate date of service:

Personal Information

Have you received services from DVSAS: Yes No If Yes, when: Please describe your experience with any of these kinds of issuses in your own life or someone close to you:
abuse in a relationship, family violence, rape, sexual harassment, incent, depression, suicide, drug & alcohol abuse, or grieving? Describe the experience/training you have had that you feel prepares you for being a DVSAS volunteer.
(if you are interested in the Children's Program, plase include you experience and traning working with children) Describe the strengths you possess that would enable you to make a contribution as a volunteer at DVSAS.
(if you are interested in the Children's Program, plase include you experience and traning working with children) Other comments:

Education

Highest Grade Completed: 9 (High School) 10 (High School) 11 (High School) 12 (High School) 13 (College / University) 14 (College / University) 15 (College / University) 16 (College / University) 17 (College / University) + Last School Attended: Dates: Major / Degree: Are you interested in applying for an intermship position: Yes No Do you have a reliable vehicle and valid driver's license: Yes No If you do not have a vehicle, do you have reliable transportation: Yes No

Work Experience

Please list you three most recent job experiences.

Employer Name: Employer Phone: Dates: Duties: May we contact them: Yes No Employer Name: Employer Phone: Dates: Duties: May we contact them: Yes No Employer Name: Employer Phone: Dates: Duties: May we contact them: Yes No

Volunteer Experience

Please list you three most recent or most relevant volunteer experiences.

Organization Name: Organization Phone: Dates: Duties: Organization Name: Organization Phone: Dates: Duties: Organization Name: Organization Phone: Dates: Duties:

References

Please give the names of three people not related to you who have know you well and can recommend you, such as teachers, employers, and family friends.

Reference #1:

Name: Phone: Relationship:

Reference #2:

Name: Phone: Relationship:

Reference #3:

Name: Phone: Relationship:

News & Events

Volunteer Application

Applicant Information

Interest in DVSAS

Personal Information

Education

Work Experience

Volunteer Experience

References

Reference #1:

Reference #2:

Reference #3: