The Discovery Trail Volunteer Application [020116]

HopeLine Reassurance Program Volunteer Application

Thank you for your interest in becoming a Reassurance Program HopeLine volunteer! At this time, we are only accepting applications from residents in North Carolina. After submitting your application please give up to 2 weeks for processing time. We will be in touch as soon as possible. Thank you!
TODAY'S DATE*

MonthDayYear
Date
Name*

First NameLast Name
Full Name*
Pronouns:

she/her/hershe/him/histhey/them/theirsOther
Date of Birth - Must be age 18 or over.*

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mailing Address - Street Name/Number, City, State and Zip Code*
Phone Number*
Please enter a valid phone number.
E-mail Address*
example@example.com
Occupation/Place of Employment
If you are a student, where do you attend school and what is your field of study?
What is your preferred method of contact?*

PhoneE-mailEither
Please summarize any special skills or qualifications that you feel you have acquired from employment, previous volunteer work, or through other activities that may be an asset to you during your time with HopeLine.
Summarize your previous volunteer experience, if applicable.
In training and while volunteering, you will be exposed to material relating to difficult topics. Those topics may include but are not limited to:
- active listening
- mental health
- death & grieving
- suicide
Do you have any reservations or concerns about any of the listed training topics? If so, please explain:
REFERENCES

Please provide the contact information [email most important] for two references, personal or professional.
Reference #1 [name, phone, e-mail, relationship]*
Reference #2 [name, phone, e-mail, relationship]*
In case of emergency, who should we contact? [name, phone number, relationship to applicant]
By signing your name in the box below, you certify that all of the information that you have provided on this application is true and correct. You also authorize HopeLine, Inc. to verify any representations made by you, whether oral or written, concerning your application for the position of volunteer. You certify that you understand that HopeLine, Inc. may contact individuals or organizations other than those you have provided as references if it feels it may be pertinent to your application for this position. HopeLine does conduct background checks for individuals selected for training class. A separate consent form will be provided when applicable.*
Any additional questions or comments:
Thank you for taking the time to complete the HopeLine Reassurance Program Volunteer application!

For next steps, you can expect to be contacted via email for a video interview. A video interview is required to be admitted to the Reassurance program training. Your references may be contacted prior to or following the interview.

If you have any questions regarding this application or the process, please contact Lynn Allen, the Program Coordinator, at 919-832-3326 or programs@hopeline-nc.org

Thanks again!
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HopeLine Reassurance Program Volunteer Application