VolunteerApplication

Have you ever been known by another name? *

No Yes

Are you at least 21 years of age or older? *

Yes No

Physical Address *

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City

State

Zip Code

Country

Mailing Address *

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State

Zip Code

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Mobile Phone Number *

Work Phone Number *

Home Phone Number *

Email Address *

Education (choose last year completed) *

What type of volunteer opportunities interest you? Check all that apply *

Special Events Marketing Crisis Advocate *Please continue application below

For Crisis Advocate Volunteer Applications Only:

List Three (3) References (Other than relatives)

Name 1 *

Relationship *

Daytime Phone *

Evening Phone *

Name 2 *

Relationship *

Daytime Phone *

Evening Phone *

Name 3 *

Relationship *

Daytime Phone *

Evening Phone *

Previous Address *

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City

State

Zip Code

Country

Please list a person or persons to notify in case of an emergency: *

Please list any experience (paid or volunteer) you feel is relevant to becoming a volunteer with Rise Above Violence: *

Please explain why you are interested in volunteering with this program: *

What is most important to you in a volunteer position? *

What personal qualities do you bring to volunteering that would be of benefit to victims of violence? *

Have you ever been a victim of crime (Domestic Violence, Sexual Assault, Burglary, etc.? *

No Yes

If yes, briefly explain, including year of incident: *

Have you had any previous experience in working with victims? *

Do you have any physical or mental health conditions that may affect your work with victim services? *

No Yes

If so, please briefly explain: *

Have you ever been arrested for a criminal act (except minor traffic offenses)? *

No Yes

If yes: Crime Charged *

Date *

Disposition *

How did you learn about our volunteer program? *

Languages spoken other than English: *

Are you able to provide transportation for a victim and/or their family? *

Yes No

Do you have a valid Colorado driver's license? *

Yes No

License No. *

Expiry Date *

Restrictions *

What amount and type of vehicle insurance do you carry? *

Have you ever had your driver's license suspended, denied or revoked? *

No Yes

If yes, please explain: *

Rise Above Violence Victim Assistance Program VOLUNTEER APPLICATION

For Crisis Advocate Volunteer Applications Only:

Rise Above Violence Victim Assistance Program
VOLUNTEER APPLICATION