Volunteer-Internship Application Thank you for your interest in volunteering/interning with Safe Passage! Please visit our website for more information regarding training dates and times. We appreciate your time and interest. Step 1 of 5 0% Name(Required) First Last Are you 18 years old or older?(Required) Yes No Date of Birth(Required) MM slash DD slash YYYY Email(Required) Phone(Required)Address(Required) Street Address Address Line 2 City State ZIP How did you hear about us?(Required) Internship/Career Fair Community Event Social Media Mailer Other I am interested in being a(n)(Required) Intern Volunteer InternshipWhich type of internship are you seeking?(Required) Bachelor's Level MSW Foundations/First internship Advanced Masters Select all programs in which you are interested(Required) Residential Legal Children's Partner Abuse Intervention Prevention and Outreach What school do you attend?(Required) What is your current major/degree program(Required) Which term are looking to start your internship?(Required) VolunteerAre you volunteering for school credit or as part of a degree requirement?(Required) Yes No Please select all volunteer areas in which you are interested. Starred positions require DV/SA advocate training.(Required) Hotline/residential* Medical On Call/Emergency medical response* Legal advocacy* Childcare/Children's program* Abuse intervention services* Prevention and community education* Donation organizer Office support Fundraising Community outreach Event organizing Gardening and/or facilities maintenance Social media ambassador Select All Interests and SkillsAre you active in any organizations?(Required) Yes No If so, please list them hereDo you speak any foreign languages?(Required) Yes No If so, please list them here Which of your current or past skills do you feel would best help the organization?(Required)Do you have any previous experience or skills in the area of domestic or sexual violence?(Required) Yes No If so, please describeWhy do you think you would be a good volunteer for Safe Passage?(Required)Personal ReferenceFirst and Last Name(Required) Relationship(Required) Phone(Required)Email(Required) Professional ReferenceFirst and Last Name(Required) Relationship(Required) Phone(Required)Email(Required) Please list the hours during the week that you will be available to volunteerEx: Monday 5pm-9pm, Tuesday 8am-5pm, Wednesday 12pm-5pm...Please indicate below if you do NOT want to receive Safe Passage's volunteer updates or agency newsletter. Opt out of agency and volunteer communicationsI understand that there is a $100 training fee.(Required)$75 will be reimbursed after successful completion of the 65 hour domestic violence and sexual assault training, along with completing the 6 month (or 2 semesters for interns) commitment. Yes, I understandVOLUNTEER CONTRACTI understand that I must complete the entire 65-hour training plus additional sit-ins before I can begin to volunteer/intern in direct-service programs. I understand that Safe Passage does not discriminate against persons based on race, religion, ethnicity, sexual orientation, or physical disability. I also understand that all volunteer/intern applicants will undergo a thorough screening process to determine if they are appropriate for the current needs of Safe Passage. In addition, acceptance of all volunteers/interns is conditional upon the positive outcome of a national criminal background check and a Child Abuse and Neglect Tracking System (CANTS) check. I hereby give Safe Passage my permission to conduct these background checks. All volunteers and interns must also complete and sign a Volunteer Contract.Electronic Applicant Signature Needed (Please type name to indicate understanding)(Required) Date(Required) MM slash DD slash YYYY