New Orleans Family Justice Center: Volunteer Medical Advocate Application
Please fill out if you are interested in participating the in the November/December 2018 medical advocate training to support survivors of sexual and domestic violence. Questions? Email advocacy@nofjc.org

In order to volunteer, you must:
1. Be at least 20 years old
2. Complete 40 hours of training (20 online and 20 in-person) provided by NOFJC
3. Complete a background check
4. Commit to volunteering at least 12 hours a month for one year

Name
Your answer
Phone Number
Your answer
Email Address
Your answer
Availability to participate in Training
Please note, volunteers must attend a total of 20 hours of in-person training. We will also provide you with a 20-hour online training to do on your own time. Some make-up times may be avaliable.
Participants must attend ALL THREE (3) training dates. I can attend training on (please check all dates that apply):
If you are unable to attend these dates and times please provide other options:
Your answer
Any additional info on your availability/scheduling (i.e. if you have a conflict, need to come late, etc.)?
Your answer
I can commit to completing a 20-hour online training (provided by NOFJC as soon as your application is accepted)
I can commit to serving for 1 year as a Medical Advocate, covering at least two 6-hour shifts per month (12 hours total per month)
I have access to reliable transportation
I am willing to submit to a background check prior to volunteering.
Have you ever perpetrated any form of sexual abuse, domestic violence, harassment, or assault? If yes, please explain.
Your answer
Tell us a little about yourself..
Why are you interested in being a medical advocate?
Your answer
Please tell us about any experience you feel is relevant that you have had in life, school, at work, etc.
Your answer
Are you proficient in any languages other than English? If so what langage?
Your answer
Please List 2 references (Name, Title, relationship, contact info)
Your answer
Thank You!
Once we review your application, we will be in touch to clear up any questions from this application and confirm your registration. If you have further questions, please contact program coordinators Amanda and Jordan at advocacy@nofjc.org
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