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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State

Zip Code

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Mailing Address *

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State

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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

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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: *

Disclaimer: This does not disqualify you from becoming a victim advocate or going through the training process. We understand some may be triggered as subjects come up in training that are disturbing. This will help us support you and prepare you for any triggers that might arise.

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