The Discovery Trail Volunteer Application [020116]

HopeLine Volunteer Application

Thank you for your interest in becoming a HopeLine volunteer! At this time, we are only accepting applications from residents of North Carolina. After submitting your application, please note that we will contact you if we wish to move forward with the next steps. Thank you for your understanding!
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 type of involvement are you seeking with HopeLine?*

Crisis Line VolunteerReassurance Program VolunteerOther
What is your preferred method of contact?*

PhoneE-mailEither
What is your availability or desired days/times to volunteer? [check all that apply]*

Monday AMMonday PMTuesday AMTuesday PMWednesday AMWednesday PMThursday AMThursday PMFriday AMFriday PMSaturday AMSaturday PMAs needed/askedSpecial EventsOther
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:
- interpersonal issues
- mental health (including depression, anxiety, and psychosis)
- health (including STDs, pregnancy, eating disorders, and substance use)
- sexuality (including sexual orientation, sex-related issues, and reproductive issues)
- domestic violence
- sexual assault
- child abuse
- 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:
Should be Empty:

HopeLine Volunteer Application