JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Volunteer Advocate Application
Thank you for showing interest in becoming a Volunteer Advocate with Pueblo Rape Crisis Services. Our Volunteer Advocates respond to the hospital and our 24/7 confidential crisis hotline. We provide confidential advocacy and support to primary and secondary survivors of sexual assault. For former clients, we are grateful that former PRCS clients want to volunteer with us. Please note that for confidentiality purposes, we ask for at least 6 months between the completion of services with us and the start of volunteering. Please fill out this application and our Volunteer Program Coordinator will contact you.
* Required
Name
*
First and last name
Your answer
Preferred Pronouns
Your answer
Date of application
*
MM
/
DD
/
YYYY
Address
*
Street, City, State, Zip
Your answer
Phone number
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Current Employer (if no current employer put N/A)
*
Your answer
Current School (if no current school put N/A)
*
Your answer
Emergency Contact
*
Name, Relationship, Phone Number
Your answer
Reference #1- Personal
*
Name, Relationship, Phone Number, Email, Years Known.
Your answer
Reference #2- Professional
*
Name, Relationship, Phone Number, Email, Years Known.
Your answer
What interested you in this volunteer position?
*
Your answer
Have you volunteered in the past? If so, where did you volunteer, what were some of your duties, and what you did enjoy?
*
Your answer
Are you able to attend Volunteer Meetings & Continuing Education opportunities?
*
Yes
No
Do you speak any other languages?
*
Yes
No
If yes to the above question, what language(s) do you speak?
Your answer
Are you able to attend all 4 days of training and complete the online portion?
*
Yes
No
Have you in the last 6 months been enrolled in any services through the PRCS Office? This includes case management.
*
Yes
No
Is there anything else you would like for the Volunteer Program Coordinator to know about yourself?
*
Your answer
Please check all qualifications that you meet. If you cannot check one this does not immediately disqualify from this volunteer position.
*
Must be at least 18 years of age, 21 preferred.
Must own a cell phone.
Must have a vehicle in working condition with insurance.
Must live in Pueblo County.
Must be willing to submit to a criminal background check.
Must be willing to obtain a set of fingerprints.
Must be able to commit to 35 hours per month of volunteer service.
Must be able to commit to one year of service with PRCS.
Must be able to respond in person to Parkview ER within 30 minutes (rare occasion other community locations)
Required
Certification
*
PLEASE TYPE YOUR NAME if the information given is true and accurate to the best of my knowledge. Any willful misrepresentation or falsification of this application will result in disqualification form my participation in the program, and/or immediate termination. I understand that submitting this application in no way guarantees my acceptance or work as a volunteer, and that I must also meet additional requirements.
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Pueblo Rape Crisis Services.
Forms
