C.A.R.E Volunteer Application

C.A.R.E Volunteer Application
Center for Abuse and Rape Emergencies P.O. Box 510234 Punta Gorda, FL. 33951 (941) 639-5499
Name*
Date of Birth*

MonthDayYear
Date
Address*

Address

Street Address Line 2

CityState / Province

Postal / Zip Code
State*
Zip Code*
Phone:*
Secondary Phone (optional):
Email*
example@example.com
YesNo
If yes where
Special training or skills that may help you in this work:
Are you fluent in any languages other than English? If yes, which?
YesNo
If yes, which?
YesNo
Tell us about your previous volunteer experiences
Area's of Volunteer Interest

(If known, check all that apply)
Hotline/ShelterOutreach/TablingHospital Response TeamCourt AdvocateGroup FacilitationOffice WorkChildcare CenterOther
If Other, please describe:
Company Center for Abuse CARE. & Rape Emergency The Victim Services Center
Center for Abuse and Rape Emergencies P.O. Box 510234 Punta Gorda, FL. 33951 (941) 639-5499

Have you ever been convicted of a felony? (A conviction does not necessarily disqualify
Have you ever been convicted of a felony A conviction does not necessarily disqualify you*
If yes please explain
Have you ever been the subject of a substantiated child abuse or neglect report Does not necessarily disqualify you*
Do you agree to a national criminal background check*
We are a drugfree environment Do you have any objections to mandatory testing*
Do you have any medical conditions we should be aware of*
How did you hear about CARE*
Why do you want to volunteer for CARE? How do you hope to benefit?*
Center for Abuse CARE. & Rape Emergency The Victim Services Center
Center for Abuse and Rape Emergencies P.O. Box 510234 Punta Gorda, FL. 33951 (941) 639-5499
Have you a friend or a family member been a victim of a crime? Please describe the situation. Were services from a victim services agency or advocate used? What was the experience like?
What else would you like us to know about you
Please list three references who can attest to your character.
Name*
Email*
example@example.com
Phone*
Format: (000) 000-0000.
Name*
Email*
example@example.com
Phone*
Format: (000) 000-0000.
Name*
Email*
example@example.com
Phone*
Format: (000) 000-0000.
Center for Abuse CARE & Rape Emergency The Victim Services Center
Center for Abuse and Rape Emergencies P.O. Box 510234 Punta Gorda, FL. 33951 (941) 639-5499

Volunteer Availability & Commitment Form

Morning (12 AM-8 AM) Afternoon (8AM-4 PM) Evening (4 PM-12 AM)

Date Restrictions or Conflicts
Morning 12am-8amAfternoon 8am-4pmEvening 4pm-12am
Morning 12am-8amAfternoon 8am-4pmEvening 4pm-12am
Morning 12am-8amAfternoon 8am-4pmEvening 4pm-12am
Morning 12am-8amAfternoon 8am-4pmEvening 4pm-12am
Morning 12am-8amAfternoon 8am-4pmEvening 4pm-12am
Morning 12am-8amAfternoon 8am-4pmEvening 4pm-12am
Morning 12am-8amAfternoon 8am-4pmEvening 4pm-12am
Please list any dates you are unavailable vacations holidays etc

MonthDayYear
Date
Do you have any preferred tasks or limitations (physical, transportation, etc?
Center for Abuse CARE. & Rape Emergency The Victim Services Center
Center for Abuse and Rape Emergencies P.O. Box 510234 Punta Gorda, FL. 33951 (941) 639-5499

Due to the subject matter, attendance at all training sessions are required in order to be fully qualified to provide direct services to victims. Emergency situations will be addressed individually with the Volunteer Coordinator.

I affirm that the above information is complete and accurate. I give permission to C.A.R.E. to verify this information and to contact the references listed. I have reviewed the volunteer job description and believe I can fulfill the responsibilities upon successful completion of the C.A.R.E. advocate training programs.
Signature*
Date*

MonthDayYear
Date
Should be Empty:

C.A.R.E Volunteer Application

Company Center for Abuse CARE. & Rape Emergency The Victim Services Center

Center for Abuse CARE. & Rape Emergency The Victim Services Center

Center for Abuse CARE & Rape Emergency The Victim Services Center

Center for Abuse CARE. & Rape Emergency The Victim Services Center