Volunteer/Internship Application

Name(Required)

First Last

Are you 18 years old or older?(Required)

Yes

No

Date of Birth(Required)

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

Internship

Which 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)

Interests and Skills

Are you active in any organizations?(Required)

Yes

No

If so, please list them here

Do 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 describe

Why do you think you would be a good volunteer for Safe Passage?(Required)

Personal Reference

First and Last Name(Required)

Relationship(Required)

Phone(Required)

Email(Required)

Professional Reference

First and Last Name(Required)

Relationship(Required)

Phone(Required)

Email(Required)

Please list the hours during the week that you will be available to volunteer

Ex: 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 communications

I 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 understand

VOLUNTEER CONTRACT

I 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)