Hotline Advocate Application - Moving to end Sexual Assault

Hotline Advocate ApplicationKyle Gordon2023-12-15T15:31:59-07:00

Volunteer Hotline Advocate Application

Personal Information
Date*
MM slash DD slash YYYY
Name*
First Last
Gender and pronouns*
Birth date*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Email*
If you are a student
Name of school Current year
Employer
Company How long Position
How long have you lived in Colorado?*
Do you have access to transportation?*
- Yes
- No
Do you have any physical limitations that require accommodation?*
- Yes
- No
Please list any languages that you speak fluently besides English*
References (preferred: two professional, one personal)
Reference #1*
Name Phone Email Relationship Years Known
Reference #2*
Name Phone Email Relationship Years Known
Reference #3*
Name Phone Email Relationship Years Known
Interests and Time Commitment
How did you hear about volunteering with MESA?*
Reasons for Volunteering (in brief)*
List two major strengths when working with people*
List two major weaknesses when working with people*
Please list any anticipated short or long-term absences longer than two weeks*
Describe your time commitments in a typical week (outlining mornings, afternoons, and evenings both weekdays and weekends)*
Background
Have you ever been terminated or released from a job or volunteer experience?*
- Yes
- No
If yes, please explain
Have you ever been convicted of or pled guilty to a criminal offense in a court of law?*
- Yes
- No
If yes, please give dates, details and penalties for each occurrence in a separate document. A "yes" does not automatically remove you from consideration for volunteering for MESA.
Max. file size: 400 MB.
Hotline Advocate
Describe any experience you have had providing emotional support to others:*
Please check all that apply*
- I will be able to attend the entire 40-hour training.
- I am willing to sign up for one 24-hr shift per month.
- I will be able to attend two evening meetings per month.
- I understand that I need to have access to a private phone while on call.
- I can and am willing to arrange access to my own transportation while on call.
I am interested in (please check all that apply)*
- Providing general support to MESA office needs, including posting of flyers and reaching out to other organizations, sending letters, making needed calls, compiling databases, etc.
- Providing support on preparing events and attending MESA annual events.
- Providing support with social media.
- Providing support in fundraising activities.
- None of the above
Certification
I certify that all information provided on this application is correct.In consideration of my acceptance of this volunteer position, I, the undersigned, do waive any and all claims for myself and my heirs against Moving to End Sexual Assault (MESA), Mental Health Center of Boulder and Broomfield Counties, Inc., any sponsors or exhibitors, and all officials and volunteers involved in this event for any injury or illness which may directly or indirectly result from my participation with Moving to End Sexual Assault even though their liability may arise out of negligence or carelessness on their part.
Name
First Last
Date
MM slash DD slash YYYY
Email
This field is for validation purposes and should be left unchanged.

58924

Hotline: 303.443.7300

Text BRAVE to 20121

Address
1455 Dixon Ave, Suite 210, Lafayette 80026
Email
For general inquiries: [email protected]
For support services and volunteers: [email protected]
Phone Numbers
Office: 303.443.0400
Fax: 303.443.0187

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Volunteer Hotline Advocate Application

Personal Information

References (preferred: two professional, one personal)

Interests and Time Commitment

Background

Hotline Advocate

Certification