Volunteer Application

* All fields are required.

Contact Information

Name

Address

City

State

Zip

At least one phone number is required.

Home Phone

Work Phone

Mobile Phone

About You

Birthday
(mm/dd/yyyy)

Are you presently working or studying?WorkingStudying

If so, where?

Your Interests

In which areas are you interested in volunteering?

Direct Service (Hotline Advocacy)

Direct Service (Face to Face Advocacy)

Non-Direct Service

Additional Questions

How did you hear about us?

Why do you want to work with sexual assault survivors?

Name 3 things that you hope to gain from your volunteer work.

Please list any past or present volunteer experiences.

Is there anything that may interfere with you attending all of the training sessions?

Have you ever been convicted of a felony? If so, please explain.

References

Please list three non-relative references whom you have known for at least one year. For each, please include a daytime phone number and their relationship to you.

Agreement

I am willing to participate in all screening, orientation and training necessary to become a volunteer with the CRCC. I understand this may include a background check at my own expense.

I understand that my attendance is required at each training session in order to successfully complete training and become an active volunteer.

I have been honest and accurate in my completion of this application.

I Agree

Emergency Contact

Please provide the name and telephone number of a person that we can contact in case of an emergency.

Cleveland Rape Crisis Center | 24 Hour Hotline: (216) 619-6192