PCC- VOLUNTEERS FORM

Crisis Line Volunteer Job Description

Domestic Violence - Sexual Assault - Child Abuse
Crisis Line Volunteer
Job Description

Purpose and Accountability: Under the direction of the Crisis Line Coordinator and the supervision of the Executive Director, the Crisis Line Volunteer shall (1) provide assistance and information to victims of domestic violence, sexual assault, and child abuse through the 24-hour Crisis Line and (2) represent the Parent-Child Center in an effective and professional manner.

Status: Crisis Line Volunteer Position

Qualifications: Willing to volunteer a minimum of three shifts per month

                                        Willing to complete required initial and on-going training

                                        Long distance service on home phone or cell-phone required

Requirements: Must be 18 years old or older

                                        Complete a volunteer application and interview

                                        Complete 40 hours training required by Parent-Child Center

                                        Must pass a background check

Duties:
- Maintain staff and client confidentiality at all times
- Complete 40-hour of Crisis Line training within 6 months of start date.
- Complete 20 hours of continuing education each year by enhance listening skills and knowledge of domestic violence, sexual assault and child abuse.
- Attendance to at least three Crisis Line Meetings or trainings per year
- Learn to transfer the crisis line using the call-forwarding system
- Schedule a minimum of three shifts per month.
- Document all calls on provided forms and submit to Parent- Child Center office in a timely manner (by the end of the month)
- Notify the office of any schedule changes.
Signature*

Clear

Parent-Child Center Volunteer Application

Domestic Violence - Sexual Assault - Child Abuse
Name:

First NameMiddle NameLast Name
Gender:

MaleFemale
Date of Birth:

MonthDayYear
Date
Phone Number:

Area CodePhone Number
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Crisis Line Coordinator will send monthly emails to remind you about training, upcoming events and to send you crisis line monthly calendar.

melissad.pcc@gmail.com
Email:
example@example.com
Employee:
Company and position
Career History/Work experience:
Do you have any specialized training that might be of benefit to this program?
What do you hope to learn from Parent-Child Center?
What are your thoughts on Domestic violence, Sexual assault and Child abuse?
If Domestic violence, Sexual assault, Child abuse is a part of your personal history; do you feel that you have been able to heal with your past experiences?
How did you hear about the Crisis line Volunteer program?
Have you been convicted of a crime?
If yes, Please explain:
Do you use illegal drugs?

YesNo
Have you ever been charged with child abuse or neglect

YesNo
Has your driver’s license ever been suspended or revoked

YesNo
If yes, please explain:
Is there any other fact or circumstance involving you or your background check that would affect your ability to provide volunteer services at PCC?

Please provide three references who are not related to you and have known you for at least two years:
Reference #1

First NameLast Name
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number:

Area CodePhone Number
Reference #2

First NameLast Name
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number:

Area CodePhone Number
Reference #3

First NameLast Name
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number:

Area CodePhone Number
I, understand that the information I have provided may be verified by contacting persons or organizations named in the application. I hereby release and agree to hold harmless from liability any person or organization that provides information. I also agree to hold harmless to Parent-Child Center, volunteers, employees, officers, and clients. I do understand that I need to maintain confidentiality and privacy at all the time.I agree to {terms & conditions}.
Type your name if you agree.

VOLUNTEER'S BACKGROUND CHECK

Domestic Violence - Sexual Assault - Child Abuse
APPLICANT DISCLOSURE AND AUTHORIZATION FORM

[IMPORTANT -- PLEASE READ CAREFULLY BEFORE SIGNING AUTHORIZATION]

DISCLAIMER: This is an end user obligation under the FCRA. This document is intended for instructional purposes only and is not intended as legal advice. We recommend you consult with an attorney to review this document and the attached state notices to ensure your compliance with applicable state laws related to background screening and consumer notices and disclosures.

DISCLOSURE REGARDING BACKGROUND INVESTIGATION
[Volunteer] Parent-Child Center may obtain information about you from a consumer reporting agency for volunteer purposes under the permissible purpose of employment. Thus, you may be the subject of a “consumer report” and/or an “investigative consumer report” which may include information about your character, general reputation, personal characteristics, and/or mode of living, which can involve personal interviews with sources such as your neighbors, friends, or associates. These reports may contain information regarding your credit history, criminal history, social security verification, motor vehicle records (“driving records”), verification of your education or employment history including current position, worker’s compensation injuries, or other background checks. You have the right, upon written request made within a reasonable time after receipt of this notice, to request disclosure of the nature and scope of any investigative consumer report conducted by [One Source The Background Check Company, PO Box 24148, Omaha, NE 68124, 1.800.608.3645, www.onesourcebackground.com]. The scope of this notice and authorization is allowing the Company to obtain from any outside organization all manners of consumer reports and investigative consumer reports now and throughout the course of your employment to the extent permitted by law. I acknowledge receipt of the DISCLOSURE REGARDING BACKGROUND INVESTIGATION and A SUMMARY OF YOUR RIGHTS UNDER THE FAIR CREDIT REPORTING ACT and certify that I have read and understand both of those documents.

ACKNOWLEDGMENT AND AUTHORIZATION
I hereby authorize the obtaining of “consumer reports” and/or “investigative consumer reports” by the Company at any time after receipt of this authorization and throughout my employment, if applicable. I agree that a facsimile (“fax”), electronic or photographic copy of this Authorization shall be as valid as the original.

PLEASE PRINT LEGIBLY
Name*

First NameMiddle NameLast Name
Other Names/Alias:

First NameLast Name
Date of Birth*

MonthDayYear
Date
Social Security #: ___-__-____

Driver's License#:* State of Driver's License:_________
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
E-mail address:*
All Previous Addresses in the (7) Years*
Please include, house number and name of the street, city, state and zip codes
Signature*

Clear
Today's date*

MonthDayYear
Date
Should be Empty:

Crisis Line Volunteer Job Description

Parent-Child Center Volunteer Application

Crisis Line Coordinator will send monthly emails to remind you about training, upcoming events and to send you crisis line monthly calendar.

Please provide three references who are not related to you and have known you for at least two years:

VOLUNTEER'S BACKGROUND CHECK