Home > Prospective Volunteer Interest Form

Personal Information



Phone Number

Street Address



Zip Code

Date of Birth


Place of Employment/Occupation

Educational Background

Do you have any previous experience as a volunteer?

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?

If yes, please list

How did you hear about the Crossroads Safehouse Volunteer Program?

Why do you want to volunteer with us?


Have you ever been convicted of a felony?

If yes, please explain

Have you ever been investigated for a domestic, animal, sexual, or child abuse offense?

If yes, please explain

Volunteer Availability and Area(s) of Interest

How long do you plan to commit to being a volunteer at Crossroads?

Can you begin volunteering immediately?

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.