Volunteer Application Form

Name*

Phone*

Cell Phone

Email*

Best Method of Contact*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Emergency Contact Name

Emergency Contact Phone Number

Are you over 18?

Yes
No

Experience

What motivates you to become a volunteer with Sagesse?

What skills would you bring to a volunteer position?

What is your understanding of domestic violence?

What education do you have?

What is your current occupation?

Please list your past employment experience.

Have you had any previous volunteer experience?

If so, what was the agency and what was your role?

Areas of Interest

Administrative Volunteer

Yes
No

This volunteer commitment is project-based, volunteers are asked to assist on an as- needed basis. Roles include: Board Office Assistance, Casino, Program Evaluation Assistance, Graphic Design, General Fundraising Activities

Direct Service Volunteer (weekly or monthly)

Yes
No

This volunteer commitment requires a regular commitment which can vary from once per week to once per month. Roles include: Peer Support Group Facilitator, Individual Mentorship Facilitator, Informal Supports Facilitator, Believe in You Group Facilitator

Please Note: Areas of interest are taken into consideration; however volunteer placement is determined by Sagesse staff.

Availability

Please indicate when you're available to volunteer. Multiple selections can be made.

Day of the week

Time of the day

Comments

References

Please provide (2) personal and (1) work-related references.

Reference 1

Include their Name, Relationship, and Email

Reference 2

Include their Name, Relationship, and Email

Reference 3

Include their Name, Relationship, and Email

How did you hear about Sagesse?