Volunteer Application

Apply online or print the paper application below!





Rape Crisis Volunteers Cumberland County
Volunteer Application
 

______________________________________________________________________________________________
First Name                                                       Middle Initial                                             Last Name
 
 
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Home Phone                                                    Work Phone                                         E-mail Address
 
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Street Address                                                  City                              State                        Zip Code                                        
 
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Birthday (Month/Day/Year)                                                                          
 
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Place of Employment                                                                                             Job Title                                              
 
Educational Background
Diploma/GED Received? _______ Yes   _______ No   If yes, date received: _________________________________
College Attended ________________________________________________________________________________
Degree Received? _______ Yes   _______ No   If yes, date received: ______________________________________
What was/is your major?__________________________________________________________________________
 
Commitment
If you are interested in working directly with our clients, can you commit to attending a training class? 
_____ Yes   _____ No
 
Are you able to commit to volunteering with RCVCC for at least one year following your completion of training? 
_____ Yes   _____ No
 
Please indicate the times you are available and prefer to do volunteer work:
     Morning       Afternoon       Evening       Overnight       Weekend
 
More about You
Please explain briefly your reasons for wanting to volunteer with RCVCC at this time:
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What skills/qualities/experience will you bring to RCVCC as a volunteer?
______________________________________________________________________________________________
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If you will be involved with RCVCC as part of an internship, practicum, or for other academic purposes, please list your requirements below (number of hours to be completed, length of placement, supervision requirements, etc.):
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
Please list any other volunteer organizations or activities you have participated in and length of service:
______________________________________________________________________________________________
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Do you speak another language? _____ Yes   _____ No
If yes, what language(s) are you fluent?
______________________________________________________________________________________________
How did you learn about RCVCC?
Media _________   United Way __________   Friend/Acquaintance _________ Other: _________________________
 
Have you ever been charged or convicted of a crime? _____ Yes   _____ No
If yes, please explain:
______________________________________________________________________________________________
______________________________________________________________________________________________
References
Reference Consent:
I do hereby authorize RCVCC to verify any representations made by me, whether oral or written, concerning my application for the position of VOLUNTEER. Further, I hold harmless any individual or firm for any information they may provide. I understand that RCVCC may contact individuals or organizations other than those I have provided as references or other information, which may be pertinent to my application for this position.
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Signature                                                                                                                                    Date
 
 
Please list 2 references below, including at least one professional reference. We prefer that your professional reference be someone who has supervised you in some capacity. NO FAMILY MEMBERS PLEASE. 
 
1)      ____________________________________________________________________________
Name (Professional)                                        Relation to you
 
Street Address              City                              State                             Zip
 
Daytime Phone                                                            Evening Phone
 
2)      ____________________________________________________________________________
Name (Professional)                                        Relation to you
 
Street Address              City                              State                             Zip
 
Daytime Phone                                                            Evening Phone
 
 
 
Please list one EMERGENCY contact.
 
___________________________________________________________________________
Name                                                               Relation to you
 
Street Address              City                              State                             Zip
 
Daytime Phone                                                            Evening Phone
 
 
Thank you for completing RCVCC Volunteer Application!
Please sign and date the application below.
 
______________________________________________________________________________________________
Signature                                                                                                                                  Date
 
If you are under the age of 18 and would like to volunteer, parental consent is required. Please have a parent or guardian sign below, giving their permission for you to be a volunteer at RCVCC.
______________________________________________________________________________________________

Parent/Guardian Signature      

 

Please send your application to:

PO Box 58332, Fayetteville, NC 28305 or

515 Ramsey Street., Fayetteville, NC 28301 or
 
Fax to: (910) 485-1365             
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