Colorado Organization for Victim Assistance
Colorado Organization for Victim Assistance
COVA
Victim Services Intern Program
Host Agency Application
DoraLee Larson, Program Director email:
1)Agency name:
2) Mailing address:
3) Physical address:
4) Phone:Fax:Email:
5) Intern’s direct supervisor’s name and title:
Secondary supervisor:
6) Executive Director/Department Manager:
7) Does your agency use interns on a regular basis and are you currently hosting interns?
8) If so, how do you recruit your interns?
9) In what capacity do you normally use interns, and what is the normal duration for an intern in your agency?
10) Are you prepared to host an intern for one year?
11) Please provide, as an attachment, a detailed outline of your agency’s volunteer / intern job description, expectations, supervision, training, and evaluation process. Please feel free to provide as many attachments as necessary.
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12) Does your agency have the space to host an intern and do your interns share office space? If so, how does that impact the work responsibilities of the intern?
13) How many interns can your agency host at any given time?
14) Do the interns have access to their own computer station and work station?
15) Will the intern have separate voice-mail, and/or a telephone?
16) Will the intern have the opportunity to attend, and be part of your staff meetings?
17) Please provide a narrative of what racial, social and cultural diversity means to you and to your agency. (Use an attachment).
18) Please provide a brief narrative (use an attachment), citing examples, of your agency’s record with issues around inclusion of different populations in the community. I.E., staff, volunteers, events, accessibility, TTY, etc.
19) Are there any categories of individuals that would not be appropriate for your agency?
20) Will your agency initiate a background check, or will your agency rely on COVA to complete a background check and criminal history?
21) Please provide a statement (i.e.,E.E.O.) about your agency’s cultural sensitivity training(s). Are the trainings mandatory for all?
22) Can your agency commit to ensuring that the COVA Victim Service Intern(s) will have the opportunity to do some capacity of direct victim services, i.e. person-to-person contact, outreach by phone, involvement in court proceedings, for a majority of their time while at your agency? (This is variableas we expect that initially Interns will receive appropriate training and introduction to the work environs of your agency, in the first few months.)
23.) Will you agree to not making any changes in the COVA Intern’s duties, placement or any other adjustments unless thoroughly discussed and approved by the COVA Victim Service Intern Program Coordinator (or other COVA Staff)?
24).What kind of expenses would your agency be willing and able to provide to the intern you host, i.e. training, housing while attending the COVA Conference?
25). Is the Intern Supervisor or Agency Supervisor able to meet with the VSI Coordinator individually?
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