HANDS OF HOPE RESOURCE CENTER
MORRISON/TODD COUNTY
P.O. BOX 67
LITTLE FALLS, MN 56345
Volunteer Application Form
NAME: _____________________________________________

HOME PHONE:_________________________BUSINESS PHONE:__________________________

ADDRESS:_____________________________________________________________________

BIRTH DATE:_________________________

CAN YOU BE CALLED AT WORK?__________

DAYS AND HOURS YOU CAN BE REACHED:___________________________________________

(Please use an additional sheet of paper if you need more room in answering any of the following questions.)

1. What is (are) your reason(s) for volunteering for this program?



2. Have you had previous volunteer experience?     YES_____NO_____
Have you volunteered with another victims program?     YES____NO____
If yes to either of these questions, please list what you did and why you stopped.



3. What can you gain from being a volunteer and what do you feel you can give to the program?



4. Do you have a particular preference for the kind of work you would do in the program (e.g. public speaking, writing, one-to-one advocacy, other )?



5. Please describe any areas about which you have strong feelings (e.g. abortion, gay/lesbian lifestyles, suicide, drug abuse, therapy, teenage sex, etc.)



6. Are there any kinds of people you feel uncomfortable around? If yes, please describe.



7. How will you be supportive of victim/survivors who have views, values, and/or lifestyles differing from your own?



8. If you have been affected by any form of abuse, please explain how are you dealing with or have dealt with the victimization.



9. Have you ever had any special training (e.g., bi-lingual skills, business trade, public speaking, communication skills, counseling, etc.) that would be relevant to working in the area of Sexual Abuse/Domestic Violence & Child Abuse.? Please describe.



10. Do you have a valid MN driver's license?     YES____NO____     LICENSE NUMBER_________________________

Do you have access to a car in safe operating condition?     YES____NO____

Name of insurance company_________________________________ Policy #_________________________

Amount of liability coverage________________________________________________________________


11. How much time can you give to the program per month?__________________________________________

Are you available for training some evenings & 2 Saturdays?     YES_____NO_____

Are you able to attend a monthly meeting held the second Monday of each month?     YES____NO____

Are you willing to make a minimum one year commitment to the program?     YES____NO____


Please list 2 references, how they know you, and how they can be reached. These people will be contacted:



I realize that the identity and circumstances of any victim/survivor(s) that I may have contact with or become aware of as a result of my participation in Hands of Hope Resource Center must be kept completely confidential. Any breach of this policy will result in my dismissal from the program.

Signature_________________________________________________Date______________________

PLEASE RETURN TO HANDS OF HOPE, P.O. Box 67, Attn: Karla, Little Falls, MN 56345 - FAX 320-632-5457

VOLAPP 7/99

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