Volunteer with G.R.O.W.

Full Name *

Date of Birth *

Month

Day

Year

Gender Identity (male, female, transgender, gender non-conforming) *

Email *

Address *

Apartment, suite, etc

City *

State/Province *

Zip Code *

Phone *

Education

Highest Level of Education *

Degree/Certificate *

Employment

Current Employer, if applicable *

Position/Title *

Dates of Employment (starting/ending) *

Address *

Apartment, suite, etc

City *

State/Province *

Zip Code *

Would you like us to keep your employer abreast of your volunteer service and achievements? *YesNo

Skills & Experience

Special training, skills, hobbies *

Groups, clubs, organizational memberships *

Availability and Volunteer Assignment Preferences

If "other", please explain *

If "other", please explain

Are you volunteering to receive credit for an internship? *YesNo

If yes, how many hours are required and what date must those hours be completed by? *

Please describe your prior volunteer experience (include organization names and dates of service) *

Please name 3 core values you believe are important when working in the field of domestic violence awareness, advocacy, and prevention *

What do you hope to gain from this volunteer experience? *

Have you ever been convicted of a crime? *YesNo

Do you consent to a background check, to include criminal and motor vehicle report? *YesNo

Do you have a valid driver's license? *YesNo

If necessary, can you provide proof of current car insurance? *YesNo

References

Please list three people who know you well and can attest to your character, skills, and dependability.

Name/Organization *

Relationship to you *

Length of Relationship *

Phone Number *

Name/Organization *

Relationship to you *

Length of Relationship *

Phone Number *

Name/Organization *

Relationship to you *

Length of Relationship *

Phone Number *

Signature *

Date *

“Life’s most persistent and urgent question is…what are you doing for others?” – Dr. Martin Luther King, Jr.

Education

Employment

Skills & Experience

Availability and Volunteer Assignment Preferences

References

“Life’s most persistent and urgent question is…what are you doing for others?”
– Dr. Martin Luther King, Jr.