Advocate Volunteer Application

ADVOCATE VOLUNTEER APPLICATION

Name:___________________________________________________________________

Address:_________________________________________________________________
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Home Telephone #:____________________ Cell Phone #:_________________________

Date of Birth:_______________________ Male:____________ Female:____________ 

How long have you lived in this area:
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Present Job:
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Occupational History:
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Educational/Special Training Background:
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1.Briefly explain why you would like to be an advocate with the Sexual Assault Program.
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2. Have you had previous volunteer experience pop over to this web-site? Please explain.
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3. Is your family supportive about your training to become a Volunteer Advocate?
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4. What personal strengths do you bring to the Program? Weaknesses?
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5. Where do you see yourself within the Program? (Example: On Call, Assisting Groups,
On-going Advocacy, Office Help, etc.) Do you have an interest of volunteering in a
specific area? Please explain.
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6. How much time do you have for this volunteer position?
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7. Are you willing to follow Program recommendations once training is completed?
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PLEASE LIST TWO REFERENCES:

Reference 1:
Name: ___________________________________________________________________
Address: _________________________________________________________________
Home Phone #: _________________________ Work Phone #: _____________________
Relationship to you: ________________________________________________________
Occupation: ______________________________________________________________

Reference 2:
Name: ___________________________________________________________________
Address: _________________________________________________________________
Home Phone #: _________________________ Work Phone #: ______________________
Relationship to you: ________________________________________________________
Occupation: ______________________________________________________________

Date: ________/________/________

Please mail to: Sexual Assault Program of Northern St. Louis County
327 1st St S Suite 17
Virginia, MN 55792
Office: (218) 749-4725