24-Hr Emergency Crisis Hotline: 757.226.YWCA (9922)

1424 McNeal Avenue, Norfolk VA 23502

T:757.625.4248 F:757.625.1946

24-hr Emergency Crisis Hotline: 757.226.YWCA (9922)

Volunteer & Intern Application

PERSONAL INFORMATION

Name of Applicant: ______

Address: City: State: Zip:

______

Home Phone: ______Alternate Phone: ______

Email Address: ______

Place of Employment: ______

Job Title: ______

Date of Birth: ______Retired? ☐ Yes ☐ No

Emergency Contact Person: ______Phone: ______

Relationship: ______

AVAILABILITY

Please place a check mark to correspond with your general availability.

Mon. / Tues. / Wed. / Thurs. / Fri. / Sat. / Sun.
Morning
Afternoon
Evening
Overnight

Do you have any physical disabilities or health concerns which would prevent you from performing certain kinds of work or in a certain work environment? ☐ Yes ☐ No

If yes, please explain: ______

Are you interested in: ☐ Volunteering ☐ Internship

EDUCATIONAL INFORMATION

Are you a student? ☐ Yes ☐ No

School: Major: Year in School:

______

What degree are you currently seeking?

☐ High School/GED ☐ Associate ☐ Bachelor ☐ Master ☐Other______

Degrees or certificates completed: ______

______

Specialty training or skills you have learned that may be used while volunteering (i.e. computer skills, speaking a second language, tutoring, crafts, technical skills, etc.) ______

______

EXPERIENCE

Have you previously worked or volunteered with the YWCA? ☐ Yes ☐ No

If so, when and what was your position? ______

Describe any current or previous volunteer experiences. ______

______

ADDITIONAL INFORMATION

Please indicate which programs or areas for which you are interested in volunteering:

☐ Women in Crisis Domestic Violence Shelters & Programs

☐ Response Sexual Assault Support Services of the YWCA

☐ YWCA Counseling Center

☐ YWCA Youth Services

☐ Legal Advocacy Program

☐ Racial Justice Initiative

☐ Administrative Office

☐ Development/Events

☐ Communications/Marketing

Please note your experiences/skills areas:

☐ Children’s Programs ☐ Public Health Awareness

☐ Teenagers’ Programs ☐ Fundraising

☐ Young Adult or College Programs ☐ Grant Writing

☐ Baby Boomer Programs ☐ Events Planning and Assisting

☐ Senior Citizen Programs ☐ Advocacy

☐ Staff Supervision ☐ Civil Rights

☐ Volunteer Relationships ☐ Hotline

☐ Group Leadership/ Team Building ☐ Homelessness

☐ Community Organizing ☐ Mental Health

☐ Business Management ☐ Substance Abuse

☐ Social Media ☐ Self-Sufficiency Skills

☐ Journalism/ Communications ☐ Financial Empowerment

☐ Computer Skills (Microsoft Office) ☐ Stress Management/ Holistic Healing

☐ Computers/IT ☐ Arts & Crafts

☐ HTML/ Web Design ☐ _Maintenance

☐ Public Speaking ☐ Counseling/ Mentoring

☐ Community Outreach/ Education ☐ Other______

For applicants interested in Women in Crisis Domestic Violence Shelters & Programs and/or Response Sexual Assault Support Services of the YWCA:

Without compromising your privacy, briefly explain your interest in volunteering for

YWCA. ______

______

______

______

Briefly describe domestic violence as you understand it. ______

______

______

______

Briefly describe sexual violence as you understand it. ______

______

______

______

Have you had any experience or training surrounding the issues of domestic violence, sexual violence, and/or the effects of trauma on children? ______

______

______

What do you perceive will be the most difficult aspect of this type of volunteer

experience? ______

______

______

ALL APPLICANTS:

I understand that all volunteers, interns, and staff of YWCA South Hampton Roads must adhere to a strict confidentiality policy. I will not divulge information about anyone accessing our services.

I hereby certify that the facts set forth in the above application are true and complete to the best of my knowledge. I understand that completing this application does not ensure a volunteer or internship placement. I also understand that this is not an application for paid employment.

Applicant’s Signature: ______Date: ______

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