Volunteer ApplicationStep 1 of 425%Personal InformationDate* MM slash DD slash YYYY Name* First Last Middle InitialAddress* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home PhoneCell PhoneWork PhoneWhen is best time to reach you by phone?Preferred Email* Age*Present EmployerEmployer PhoneJob TitleHoursProfessional ReferencesPlease list 2 professional references such as employer, teacher, or supervisor. Please do not list close friends or relatives.Reference #1* First Last Reference #1 Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Reference #1 Phone*Reference #1 Relationship*Reference #2* First Last Reference #2 Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Reference #2 Phone*Reference #2 Relationship*How did you learn about The Women's Center?*Poster / FlyerTelevisionInternetNewspaperRadioThe Women's Center AdvocateOtherVolunteer PositionVolunteers have the opportunity to participate in Advocate Training, a four part series which provides education on the realities of domestic and sexual violence. This training is required for volunteers who will be working directly with clients and is offered at no cost to participants. Other positions (indirect) can begin volunteering after a brief orientation. All on-going volunteers must be 18 years old.Advocate Volunteer Positions (Direct) - Please check the one(s) that are most interesting to you.* Receptionist On Call Advocate Gentle Man Childcare Hotline / Shelter None of the aboveGeneral Positions (Indirect) - please check the one(s) that are most interesting to you.* Maintenance / Lighting Cleaning Food Pantry / Donation Sorting Fundraising General Clerical / Mailings Special Events Special Projects Gardening / Yard Maintenance Data Entry None of the aboveWhen are you available?* Monday Tuesday Wednesday Thursday Friday SaturdayPlease selects days you are available. Specific times will be discussed at the time of the interview.Education & Personal Background InformationEducation - include any degrees earned*I am proficient in the following software: Word Excel Publisher Adobe Indesign PhotoshopOther SoftwareHobbies & Interests*SkillsList any skills you have that will be helpful to your volunteer positions. These skills can range from employment and/or volunteer experiences to life experiences you have had. Keep in mind that experience is not necessary to become a volunteer.How did you decide to become a volunteer at The Women's Center?*Are you multilingual?* Yes NoWhat language(s) do you speak fluently?Background Check InformationSocial Security Number Last 4 DigitsIf you prefer not to submit your social security number with this form please call 262-522-3845.Date of Birth MM slash DD slash YYYY Have you ever been convicted of a crime or pleaded no contest for any offense or violation other than minor traffic offenses? Yes NoIf yes, please explain 1) the nature of the crime, 2)date of conviction, and 3)county and state in which convicted.Do you have any pending charges against you? Yes NoIf yes, please explain 1) the nature of the crime, 2)date of conviction, and 3)county and state in which convicted.Please note, to volunteer at The Women's Center, you must not have used services within the past five years. Have you used services in the past five years?* Yes NoSignatureI certify that the statements herein are correct and true to the best of my knowledge. I understand that, as a volunteer, falsified statements on this application shall be considered cause for dismissal. Confidentiality in all matters relating to clients and various programs is absolutely essential. It is The Women’s Center’s policy to hold confidential all observations and information made by and between or about The Women’s Center’s clients and program participants. Also confidential are conversations between co-workers and volunteers. All staff and volunteers of The Center are subject to this policy.Name First Last Date MM slash DD slash YYYY PhoneThis field is for validation purposes and should be left unchanged.
