Personal Information Name Email Phone Number Street Address City State Zip Code Date of Birth Experience Place of Employment/Occupation Educational Background Do you have any previous experience as a volunteer? YesNo If yes, please list the name of the organization(s), your role(s), and the approximates date(s) of your service Do you speak any languages in addition to English? YesNo If yes, please list How did you hear about the Crossroads Safehouse Volunteer Program? Why do you want to volunteer with us? Background Have you ever been convicted of a felony? YesNo If yes, please explain Have you ever been investigated for a domestic, animal, sexual, or child abuse offense? YesNo If yes, please explain Volunteer Availability and Area(s) of Interest How long do you plan to commit to being a volunteer at Crossroads? 6-12 months1-2 yearsIndefinitely Can you begin volunteering immediately? YesNo If no, when can you begin? Please list the times you are available to volunteer Please select your area(s) of interest Direct Service (15-Hour Core Training Required) Shelter Support AdvocateDART Advocate (Domestic Abuse Response Team) Please note that all prospective volunteers must provide three references. Reference forms are available here.