One in Four…

Raising awareness about issues related to domestic & dating violence

FVPC Volunteer Application November 22, 2010

Family Violence Prevention Center of Orange County

Volunteer Application

(fill free to email this form to yourself!)

I am interested in volunteering as a (please check all that apply):

  • Overnight Hotline Advocate (on call evenings and/or weekends)
  • Daytime Hotline Advocate (in office 9-1 or 1-5 M-F)
  • Spanish Language Interpreter (as needed on case-by-case basis)
  • Child Care Provider
  • Court Advocate
  • Community Educator
  • Fundraiser
  • Office/Special Events Volunteer
  • Internship        (8-40 hrs per week)

Name:____________________________________________________

 

Current address:________________________________ _________________________________

City             State           Zip Code

If applicable, please list your past addresses if less than 10 years at current addresses.

Current address:________________________________ _________________________________

City             State           Zip Code

Current address:________________________________ _________________________________

City             State           Zip Code

Current address:________________________________ _________________________________

City             State           Zip Code

Email:_____________________________________

 

Telephone: (home) ________________ (work) ___________________ (cell) __________________

Date of Birth:_______________________Gender: ___________

 

Occupation:___________     Employer/School: _________________

How did you hear about FVPC? _____________________________________________________

 

Do you speak a 2nd language? ____________ Which language(s)? ______________________

 

Hotline Advocates must commit to a minimum of 4 hrs per week and interns must commit to a minimum of 8 hours per week. How many hours per week are you interested in volunteering /interning with us?_______________________________________

Our office strives to be an accessible space for all people.  What, if any, assistance will you need while volunteering?

What relevant experience / skills do you bring [personal or professional] which might be useful to FVPC?

What experience do you hope to gain through volunteering at FVPC?

We offer extensive training for all volunteers.

  • We offer extensive training for all volunteers.  The dates for the Fall 2011 Hotline Advocate* training begin Tuesday September 6 and run for 6 weeks on Tuesday and Thursday evenings from 5:30-9:00 pm at The Seymour Center in Chapel Hill.  The complete dates are: 9/6, 9/8, 9/13, 9/15, 9/20, 9/22, 10/4, 10/6, 10/11, 10/13, 10/18 and 10/20.  We are off the week of September 26.
  • The training sessions for Community Educators are less overall training hours and their dates are TBD.

Do you have any personal or professional commitments that would prevent you from attending the training? _____________

We ask that volunteers make a 9-month commitment subsequent to training to work with us.  Interns are required to make a minimum 1 semester commitment. Can you make such a commitment?_______________________________

Hotline advocates are required to complete 3 (4-hour) shadowing shifts post training and commit to 8 hours of continuing education training annually.  Can you make such a commitment?  _______________________________

If so, are you anticipating any significant life changes in those 9 months? (example:  graduating, job searching, moving, etc.): ______________________________________

Have you ever been convicted of a crime (other than a traffic violation) or received a verdict of anything other than “not guilty” in any criminal investigation for which the records have not been expunged or sealed? (such conviction may be relevant if job related but does not automatically bar you from employment)

______________No

_____________ Yes (if yes, please describe the nature, date, location and final disposition of the case below).

Is there anything else you wish to tell us?
References

Please list 3 references (two of whom must be professional or academic references, preferably individuals who have supervised you in some capacity):

1.  Name: ___________________________________ Relationship: ________________________

 

Email: __________________

 

2.  Name: ___________________________________ Relationship: __________________

 

Email: __________________

3.  Name: ___________________________________ Relationship: __________________

Email: __________________

 

I do hereby authorize the Family Violence Prevention Center of Orange County (FVPC) to verify any representations made by me, whether oral or written, concerning my application for the position of Volunteer or Intern. I understand that FVPC may contact individuals or organizations other than those I have provided as references or other information, which it feels, may be pertinent to my application for this position.

If I am applying as an Intern, I understand that, if accepted, my internship will be unpaid.  For direct service volunteers (advocate and childcare providers):  I authorize FVPC to run a criminal background check.  Prior to training, I will fill out the appropriate paperwork.

__________________________         _____________________

Signature                                                     Date

Thank you very much for your interest in volunteering with us!

If you have any questions, please contact Elizabeth M. Johnson, Volunteer Coordinator at 919-929-3872 or via email at vccoordinator(at)fvpcoc.org

 

One Response to “FVPC Volunteer Application”

  1. […] FVPC Volunteer Application […]


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