CRG Apprenticeships, Applications to Join Volunteer Roster

CRG Apprenticeships, Applications to Join Volunteer Roster

This form will be used for internal purposes only; info is collected, transmitted and stored with attention to protecting personally sensitive data. After you submit this form, we will be in touch about next steps. Thanks for your interest!
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please provide information on your previous training, including the dates, number of hours, sponsoring organization, location, etc. We particularly need this for your Basic Mediation Training, but would also like to know about any other mediation-related training you have had.*
If you have previously led mediations as a mediator, please tell us about your experience (approximate number and kind of cases, when you did it, under whose auspices, etc.)
What are your goals related to this work? What do you hope will happen as a result of your volunteering, apprenticing with CRG?*
During this pandemic, our mediations are mostly done online (usually via zoom), with occasional phone mediations. Have you done any mediations using one of these modes, or had training in them? (It's OK if you haven't!) Please check all that apply.*

Online/remote mediationMediation via zoomMediation by phoneNone of the aboveOther
At this point, how much time could you possibly spend volunteering (ex. 2 hrs/mo or up to 5 hours every week), and on what kind of schedule (ex. evenings only, can't do mornings)? *
What length of commitment could you make to this volunteer work? How does this fit into your plans for the future?*
Our funders ask us for demographic information about our mediators, in part to review how well our mediators reflect the communities we serve. To the degree you'd be willing to provide it, we would be grateful for your sharing the following details. (Only aggregated info will be provided to funders, without any identifying personal info.)
Languages spoken, degree of fluency
Highest level of education
How old are you?
What gender description are you most comfortable with?
Race
Ethnicity (Hispanic/Non-Hispanic)
Low-income (yes/no/other response)
Anything else you'd like us to know about you? Any supports you'd need to be able to participate as a volunteer mediator? Any questions or requests for us?
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