Home > Prospective Volunteer Interest Form

    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?

    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?

    Background

    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.

    ESCAPE