Counselor Advocate Volunteer Application


Date of Application:
Name:
Local Phone:
Other Phone:
Local Address: Address line1:
Address line2:
City: State: Zip:
Permanent Address: Address line1:
Address line2:
City: State: Zip:
E-mail address:
Occupation:

If you are a student please complete the following :
School:
Major/Minor:
Year of Graduation:

In conjunction with Women Gender Sexuality Studies, Rape Crisis Services offers academic practicum credits for training to UMass students in good standing who meet the qualifications.
Are you interested in receiving academic credit for your participation in training? YesNo                                                              

Please provide two references :
Name:
Phone:
Address:
Relationship:

Name:

Phone:
Address:
Relationship:


Please answer the following questions.
1.Why do you want to be a volunteer at Center for Women and Community?
2.Describe your understanding of diversity and your experience working with diverse populations.
3.What do you think are 2 or 3 of the causes of sexual assault in US culture?
4.Please list and describe any experience you have counseling or educating others.
5.What will you bring to this position?
6.What skills do you hope to develop while in this position?
7.What would be the most challenging aspect of this work for you?
8.Are you fluent or conversational in any languages other than English? What are they?
9.Can you commit to volunteering as a Counselor Advocate for a minimum of 1 year after completing the training? Yes No
If No, please explain

10.What is your availability during the December/New Year Holidays?
11.What is your availability during January?
12.What is your availability during June-August?

13.Can you attend all training sessions on Monday and every other Wednesday evenings from 5-8 PM during the Fall semester and one full
weekend session on September 20th-21st? Yes No
If No, please explain

14.Can you staff 4 hotline shifts per month after training? Yes No
If No, please explain

15.Do you have access to a car? Yes No

16.Please supply any additional information that might help us in considering your application.

This is challenging, rewarding, and life changing work! Thank you for your interest! We'll be in touch soon.
CONTACT : Center for Women and Community, New Africa House, UMASS, (413) 545-0883