Family Navigator Application form
The Center for Family Involvement is recruiting culturally and linguistically diverse parents and/or primary caregivers to volunteer as Family Navigators. Family Navigators are parents and/or primary caregivers who are currently supporting (or have supported) a family member with a developmental disability or special health care need. If you meet that primary qualification and are interested in serving as a Family Navigator, please complete the following application. If you do not have your 2 reference letters at the time of application submission, please email or fax them to Nickie Brandenburger at or (804) 827-0107
Email *
Name *
First and last name
Home address (Please include street, city and zip) *
Phone number *
Which of the following best describes you? (as it relates to a person with a disability) *
How long have you lived in the area? *
Are you or your spouse in the Military? *
Please describe your formal Education (highest year of school completed) *
If you speak a foreign language please indicate which language below.
Do you use American Sign Language (ASL)? *
Do you have access to reliable transportation? *
Do you have regular access to the internet? *
Are you currently employed? *
Please describe current work and/or volunteer experience. *
Please indicate any training, workshops, webinars or certifications related to the disability field and or supporting others. *
What is the age of your family member with a disability *
Please describe the disabilities of your family member or yourself (if applicable). *
All of us have busy lives. When a family calls for help, CFI strives to match them with a Family Navigator who makes an initial contact within 24 hours, will there be any difficulty in meeting this expectation. *
What do you consider is/are your area(s) of expertise in terms of supporting a person with a disability? *
What strengths and abilities do you have that would make you a good Family navigator? *
Of which of the following topic areas would you like to learn more about? Please check all that apply *
Summarize your experiences supporting people with disabilities and their family members. This can include an extended family member, neighbor, or someone you met at a doctor's office. *
There is an initial 8-10 hour skill building training and a series of self-pace instruction for Family Navigators, are you able to commit to participating and completing the training? *
How flexible is your schedule for participating in on-going training that might take place in person or over the internet? *
Are you willing to commit to one year of volunteer service for at least five hours a month? *
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