Project Safeguard by HC120912111619

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									                               Project Safeguard
                                     Working for Justice for Abused Women



                               VOLUNTEER APPLICATION
                   Interview Date:                                   Time:

Name_______________ ___________________________DOB_________________

Address:

City, State, Zip

Phone (H)                              Work                                 Cell

E-mail address

Education:

High School                                             City/State _____________________________

College                                       Majors

Post Graduate


Emergency Contact:                                           Phone:

Relationship:


Please list the days and hours you are available to volunteer. Most of our work 8:30 to 4:00 p.m.
Limited opportunities are available on weekends.

Monday                                        Tuesday

Wednesday                                     Thursday

Friday                                        Weekend

How many hours per week are you available to volunteer? _______________________

After completing training, with exceptions of emergencies and vacations, would you be willing to
make a six-month commitment? ___________________________________



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                             Project Safeguard
                                 Working for Justice for Abused Women

In what positions are you interested?
      ________ Telephone crisis intervention and follow-up.

       ________ Court advocacy and accompaniment (TPO and PPO)

       ________ Pro Se Legal Clinic (Divorce & Custody) Tuesdays, 5:30 – 7:30 p.m.

       ________ CourtWatch

Do you have any special skills in the following areas?
      ________ Grant Writing

       ________ Fundraising

       ________ Computer Programs

       ________ Other ____________________________________

Do you speak other languages: If yes, which ones _____________________________

Do you know sign language? ______________________________________________

Have you ever been convicted of an offense against the law? _____________________

If yes, specify (omitting traffic violations and offenses adjudicated in Juvenile Court or under a
youth offender law.)


How did you hear about Project Safeguard? __________________________________

Have you had any previous education or special training on domestic violence? ______
If yes, please specify ____________________________________________________
______________________________________________________________________

Ave you had any previous education or special training on domestic violence? _______
If yes, please specify_____________________________________________________
______________________________________________________________________

References (1 professional and 1 personal):
Name                                         Phone_____________________
Relationship
Name______________________________________ Phone_____________________
Relationship____________________________________________________________

                       Thank you for your interest in Project Safeguard
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