Crime Survivors Volunteer Application

Interests
Tell us in which areas you are interested in volunteering

Events
Fundraising
Community Outreach
Volunteer coordination
Special Skills or Qualifications
Summarize special skills and qualifications you have acquired from employment, previous volunteer work, or through other activities, including hobbies or sports.

Previous Volunteer Experience
Summarize your previous volunteer experience.


Current Employment Information

Company Name
Street Address
City ST ZIP Code
Phone
Supervisor Name

Reference #1

Name
Street Address
City ST ZIP Code
Home Phone
Work Phone
E-Mail Address
Relationship to Reference
Reference #2

Name
Street Address
City ST ZIP Code
Home Phone
Work Phone
E-Mail Address
Relationship to Reference
School Information (if applicable for internship or graduation requirement)

School Name
Street Address
City ST ZIP Code
Phone
Contact Name

Agreement and Signature
By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted as a volunteer, any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate dismissal.

Name (printed)
Signature
Date
Our Policy
It is the policy of this organization to provide equal opportunities without regard to race, color, religion, national origin, gender, sexual preference, age, or disability. Thank you for completing this application form and for your interest in volunteering with us. Please be advised you may be asked to submit to a full background check prior to volunteering with Crime Survivors, Inc..