Black Women Revolt Winter 2023 DV Training Registration Form

Spring 2025 Domestic Violence Advocate Training Sessions JANUARY 8 - 14, 2024
This application provides us with important information about your interests, skills, and readiness for anti-violence training and volunteer work. Please fill it out thoughtfully and completely. Any incomplete applications will be deleted after one week. The Black Women Revolt Against Domestic Violence reserves the right to decline any applicant based on appropriateness of match to the needs of the agency. Spaces are very limited and priority is given to incoming volunteers for the Black Women Revolt Against Domestic Violence, Staff from Domestic Violence Agencies and Service Providers around the San Francisco Bay Area. Bi-lingual/Bi-cultural Spanish speakers are strong encouraged to apply!
44-Hour Training Format

The required curriculum will be presented EXCLUSIVELY ONLINE! This requires online training with staff from organizations that are well-established in the field of Domestic Violence and related areas. This training also includes 4 hours of culturally relevant training for working with black families. Additional required videos, readings, and homework that will complement our online Zoom presentations and discussions. In order to participate in this training you are required to: 1) have access to a computer with a webcam and microphone, 2) have access to the internet, 3) have Zoom.us downloaded on a computer, and 4) be registered to participate in this training and payment made in full by the first day of class.
Full Name*

PrefixFirst NameLast Name
Preferred Pronouns*

She/Her/HersHe/Him/HisThem/They
Institution or Affliated Organization Name*
Your E-mail*
Mobile Number *

Area CodePhone Number
Work Telephone Number*

Area CodePhone Number
Your Personal Address (your certificate will be mailed)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Sharing the following information about yourself helps us better understand the communities we reach.
What is your Birthdate?*
What is your gender?*
What is your race or ethnicity? *
Do you speak any languages other than English and if so, what languages do you speak?
Are you a Clergy Member or Lay Church worker?*

YesNo
If yes, please list your Title and Name of Church.
Briefly describe why you are interested in attending this training?*

Required for my Employment at another agency (other than Black Women Revolt Against Domestic Violence)Required for me to Volunteer at another Agency (other than Black Women Revolt Against Domestic Violence)Volunteering at Black Women Revolt Against Domestic Violence (You are required to pass an interview process to volunteer with Black Women Revolt Against Domestic Violence you are required to complete the volunteer screening process)BWRADV Youth Advisory Council MemberFaith Based Round Table Member
Please select one of the following options to sign up for this 44-Hour Training:*

Black Women Revolt Against Domestic Violence Staff or Volunteers (with a commitment of 4 hours per week for 1 year) If you are volunteering at Black Women Revolt Against Domestic Violence we require a one-year commitment of volunteers who take our training, a minimum of 120 hours upon completion of the training, and one shift per week for at least 4 hours. If you need to have the fee waived due to hardship, please talk to our Co-Executive Director, Pam Tate directly. The fee for training is only $75.00 (to be paid in advance.Domestic Violence Training Fee for government or non-profit agencies in the SFDVC $200.00 (to be paid in advance)Domestic Violence Training Fee for Clergy and Lay Church Workers $200.00 (to be paid in advance)Domestic Violence Training Fee for government or non-profit agencies outside of San Francisco $250.00 (to be paid in advance)I am a part of the Healing Roots Collaborative with Blue Cross Foundation and my course will be paid by them.
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Spring 2025 Domestic Violence Advocate Training Sessions JANUARY 8 - 14, 2024

44-Hour Training Format