Coalition to End Human Trafficking Community Member Application

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On behalf of the Coalition to End Human Trafficking (Coachella Valley/Riverside County), community members have the opportunity to provide ongoing support to the Coalition, receive coalition updates, and receive specialized training by Coalition staff. By completing this application, you agree to participate in two Coalition related events throughout the year. We thank you in your support to End Human Trafficking in the Coachella Valley and Riverside County!

Email *

If you wish to support the work of the Coalition to End Human Trafficking but are unable to agree to the aforementioned time commitment, we welcome you to consider making a donation to the Coalition's efforts. Please visit the link below if you wish to do so.

https://www.classy.org/give/293617/#!/donation/checkout?c_src=BSCC-SITE

I am interested in volunteering time to support how the Coalition to End Human Trafficking responds to human trafficking. *

Yes

I am a survivor of human trafficking (sex/labor trafficking, child exploitation, etc.). *

Yes

Full Name: *

Preferred Gender Pronouns: *

She/Her/Hers

He/Him/His

They/Them

Other:

Mailing Address: *

Phone Number: *

Preferred Contact Method: *

Phone

Required

Birthdate: *

YYYY

Race/Ethnic Background: *

Hispanic / Latino

White

African American

American Indian or Alaska Native

Asian

Native Hawaiian or Other Pacific Islander

Other:

Describe any professional, educational, or personal experience that would be an exceptional volunteer for the Coalition.
*

Do you speak any additional languages other than English? *

Availability (Pacific Standard Time): *

Morning (8am - 11am)

Afternoon (11am - 2pm)

Late Afternoon (2pm - 5pm)

Evening (5pm - 7pm)

Weekends

Required

How did you hear about the Riverside County Coalition to End Human Trafficking? *

Reference Name: *

Reference Relationship: *

Reference Contact Information (Email and Phone Number): *

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