Advocates Against Family Violence

TEAMaction Volunteer Advocate Training Application

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DOMESTIC VIOLENCE ADVOCACY

CERTIFICATION TRAINING APPLICATION

All information is confidential. Please print.

Thank you for your interest in the Certification training.

 

** print application and complete **

 

Mail your completed application to:

SILVER LININGS

505 N. 4th Avenue

Pasco, WA 99301

Date ______________________________________

 

Name ____________________________________________  

 

 

Address__________________________________________

 

City _______________  State ___  Zip Code __________

 

Daytime Phone __________________________________

 

Evening Phone __________________________________

 

E-Mail ___________________________________________

 

Emergency Contact  (name, relationship, phone) _________________________________________________

 

_________________________________________________

 

**Please note this is the initial application for all potential advocates that wish to become a volunteer advocate with Silver Linings.  Further training Guidelines will be sent to you prior to attendance of this course.  Any person under the age of 18; must have a parent or legal guardian sign and submit a training permission form to participate in TEAMaction Volunteer Advocate Training.

 

What is your interest in being certified as a Domestic Violence Advocate?

 

 

 

 

 

What qualities or experience would you bring to the training that you feel would be helpful?

 

 

 

 

 

What are your strongest assets?

 

 

 

 

Are you a survivor of domestic violence, childhood abuse, sexual assault or child sexual assault?  (Please identify which)

 

 

 

 

If yes, when did the abuse occur?

 

 

 

 

If yes to above question, did you seek counseling or support services?

 

 

 

 

 

If yes, when and where?

 

 

 

 

 

Have you ever been convicted of any domestic violence or sexual assault related crimes?

 

 

 

 

Have you ever had a Domestic Violence Protection Order, Anti-Harassment Order, or different Protection Order issued against you?  If yes,  please explain the situation.

 

 

 

 

 

In order to receive certification you must attend all training dates.  Are you able to commit to a 35 hours of training?

 

 

 

How did you learn of the Certification training?

 

 _____ Newspaper                _____ Television

 _____ Radio                         _____ Flyer

 _____ Agency                      _____ Friend             

 _____ Other: _______________________

 

 

Is there anything else we should know about you?

 

 

 

 

 

 

 

 

Please list two references:

 

Name and relationship to applicant: _______________________

___________________________________________________________

Address:__________________________________________________

City, State, Zip: ___________________________________________

Phone: _____________________________ 

Best time to call _____________ am / pm

Email: ____________________________________________________

 

 

Name and relationship to applicant: _______________________

___________________________________________________________

Address:__________________________________________________

City, State, Zip: ___________________________________________

Phone: _____________________________ 

Best time to call _____________ am / pm

Email: ____________________________________________________

 

 

         A telephone or in person interview will be conducted at the discretion of the Community Educators with Silver Linings prior to starting training.

 

         Please note:  Certification training is offered at a discounted rate to those making a six month volunteer commitment ($25.00 cost of manual only).  For those not committing to the volunteer program, the cost of training is $50.00, to be paid in full before or on the first day of training. Scholarships are available. 

 

         Checks and money orders should be made out to:  Silver Linings

 

 

(   )  I am interest in volunteering.

If you would like to email this application to us the directions are below!
  1. Manually highlight the entire text by clicking EDIT and choosing SELECT ALL and then click COPY
  2. Copy & Paste to a Word document or other supporting program.
  3. Complete the application in word processing format
  4. Click FILE, Select SEND and then click PAGE BY E-MAIL.
  5. Send to volunteer@dvservices.org
A Silver Linings staff member will contact you regarding training dates and any other questions you may have on your volunteer application.