LSC Volunteer and Board Application

Services for Victims of Domestic Violence and Sexual Assault Support for the Central Peninsula's Families
NAME
DATE

MonthDayYear
Date
MAILING ADDRESS
EMAIL
example@example.com
HOME PHONE
CELL
WORK
OCCUPATION
EDUCATION ANDOR MAJOR COURSE WORK
VOLUNTEER OR WORK EXPERIENCE
Why do you want to volunteer in the domestic violence field?
How did you hear about The LeeShore Center
Please check all of the following volunteer opportunities that interest you:

Emergency ShelterTransitional HousingLegal AdvocacyViolence Prevention/OutreachDonations/Clothes ClosetBoard MemberOffice/ClericalDevelopment/FundraisingFacilities/GroundskeepingOutreach/Public SpeakingSpecial Events/Planning
Special Skills
Appropriate training is provided for each volunteer position. For those interested in working directly with clients a training requirement is the completion of the agency's 40-hour Community Awareness Workshop, which is offered in April and October each year. Other volunteers are welcome to attend. Due to the confidentiality of our clients, we also require volunteers working directly with clients to submit information so that we may conduct state and federal background checks. A Release of Information form will be required. As per agency policy, all potential and current volunteers who have or are receiving services at The LeeShore Center must discontinue volunteering until six (6) months have lapsed from the last date of service. We like to show recognition and our thanks to our volunteers through our quarterly newsletter and other venues.
Do you give permission for us to release your name:

YesNo
Would you like to receive The LeeShore Center newsletter?

YesNo
REFERENCES: please provide 3 references. You may include professional work reference and/or community volunteer work reference. Please include a contact name and phone number or email.
325 S. Spruce St. Kenai, AK 99611

Business Line: 283-9479 Crisis Line: 283-7257 Fax Line: 283-5844
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