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Legal Link Ambassador Application
Thank you for your interest in serving as a Legal Link Ambassador!
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* Indicates required question
Name (First + Last)
*
Your answer
Pronoun
*
She/Her/Hers
They/Them/Theirs
He/Him/His
Other:
Organization
*
Your answer
How long have you worked at your current organization?
(Example: 6 months, 1 year, 5 years, etc.)
*
Your answer
County where you provide services.
(Many organizations serve more than 1 county - please just list the county/counties where you provide services directly to clients as a part of your case management role. If you provide services in more than one county please select every county where you provide services.)
*
Alameda
Contra Costa
Marin
Sacramento
San Francisco
San Mateo
Santa Clara
San Joaquin
Solano
Stanislaus
Other:
Required
Organizational staff email (ex: yourname@organization)
*
Your answer
Job Title (ex: Program Coordinator, Case Manager, etc.)
*
Your answer
Phone number where you can be reached (work, or work cell preferred).
*
Your answer
How did you learn about the Ambassador program? (Please check all that apply)
*
Word of mouth (other staff/colleagues at my organization)
The Navigator Newsletter (comes from Legal Link)
My direct supervisor encouraged me to sign-up
Other:
Required
Do you work with clients directly in your role?
*
Yes
No
Is case management a part of your role?
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Yes
No
How long have you engaged in case management in your current role?
(Example: 6 months, 1 year, 5 years, etc.)
*
Your answer
If you engage in case management is it mostly short-term, or long-term?
*
Short-term (30-days or less)
Short-term extended (more than 30-days less than 6 months)
Long-term (6 months to 1-year)
Long-term extended (Longer than 1-year)
Not applicable (no caseload)
If you provide direct case management services, what is your average caseload size?
*
0-5
5-10
10-15
15-20
20+
Not applicable (no caseload)
If you provide direct services, can you please describe the client population you work with? (example: Youth, Seniors, people with disabilities, veterans, LGBT+, BIPOC, low-income, etc.)
*
Your answer
Do you have other case management experience from other past work experience? If yes, please describe, if not please type n/a.
*
Your answer
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