Granville County's Domestic Violence and Sexual Assault Agency

VOLUNTEER APPLICATION

Name *

Email *

Phone Number *

Address *

City and State *

Date of Birth *

Gender

I am interested in:

Or volunteer in another capacity:

Are you currently employed?

If Yes, Where are you employed?

How did you hear about Families Living Violence Free?

Do you speak a second language? If so, which language?

Expected length of volunteer commitment

Past relevant experience, if any

What experience do you hope to gain through volunteering?

Do you have any personal experience with domestic violence or sexual assault victims/survivors?

Have you ever been arrested or convicted for a criminal offense, other than minor traffic violations?

If yes, please explain.

Any additional comments or questions?

References:

Name

Phone Number

Name

Phone Number

By checking the box below, I certify that all of the above information is true to the best of my knowledge.

OUR MISSION:

“Giving Voice and Support to Domestic Violence and Sexual Assault Victims.”