PASSAGES, Inc. Volunteer Application
Name
First Name
Last Name
Email
example@example.com
Date of Birth
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Best way to reach you
Please Select
Phone
E-mail
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Educational Background
Job Title and Employer
Do you have your own transportation?
Yes
No
Please check what clearances you currently have
Act 33
Act 34
FBI Fingerprints
Type a question
Have you ever been convicted of a crime? If yes, please explain:
What aspects of your life have prepared you to volunteer with PASSAGES, Inc.?
How did you hear about PASSAGES, Inc. and our volunteer opportunities?
Have you volunteered with other organizations in the past? If so what sort of work did you do there?
Are you comfortable working with both females and males of all races, ethnic backgrounds, orientation, and different value systems? If no, please explain:
Describe the qualities you believe are necessary to be an effective sexual assault crisis volunteer, and do you believe you posses these qualities?
PASSAGES, Inc. offers volunteer opportunities as a medical/legal advocate and as an outreach/event advocate. Please select what opportunities you are interested in.
Medical/Legal
Outreach/Events
What area are you available to volunteer in?
Clarion County
Clearfield and Jefferson Counties
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Reference 1: Please include their name, relationship to you, and phone number
Reference 2: Please include their name, relationship to you, and phone number
Reference 3: Please include their name, relationship to you, and phone number
Is there anything else that you would like to add about your application?
I certify that the information contained in this application is correct to the best of my knowledge and I understand that falsification of this information is grounds for dismissal from the volunteer program. I authorize the references listed above to give you any and all information concerning my previous employment/volunteer history and any pertinent information they have, personal or otherwise, and release all parties from liability for any damages from furnishing same to you. In consideration of my volunteer work, I agree to conform to the policies and procedures of PASSAGES, Inc.
Thank you for your interest in volunteering with PASSAGES, Inc.
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