Crisis Center Volunteer Application

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First and Last Name (use the name you'd like to be called) *

Gender Pronouns (optional)

Address (city, state, zip) *

Phone *

Email *

I prefer to be contacted by *

Phone

Required

Date of Birth *

YYYY

Education Level *

Still in High School

High School Graduate or GED

Some College

College Graduate

Advanced Degree

How did you hear about the Crisis Center (let us know if you were referred by a current or former volunteer so we can thank them!) *

Have you used Crisis Center Services in the past year? *

Yes

Tell us about your volunteer experience:

Are you a member of any organizations?

Have you ever applied or trained to be a Crisis Center volunteer? *

I have never applied to be a Crisis Center volunteer before now.

Applied, but did not train

Trained, but did not volunteer

Trained and volunteered

Are you able to commit to a year of service (2-4 shifts a month) *

Yes

Other:

Does your support system know and approve of you doing this kind of work? *

Yes

Other:

Do you, or someone close to you, have a history of substance use or mental illness? *

Yes- me

Yes- someone I'm close to

Required

Have you, or someone close to you, made a suicide attemp? *

Yes- me

Yes- someone I'm close to

Required

Have you, or someone you're close to, experienced sexual assault or abuse? *

Yes- me

Yes- someone I'm close to

Required

Have you ever been convicted of a felony? *

Yes

Are you currently seeing a mental health professional for services, and if so, are you able to get a letter stating that you are able to do crisis work? *

Yes

Other:

Please select the program you'd like to apply for: *

Crisis and Suicide Line

Rape Response

Senior Talk Line

UTalk

Recovery Resource Center

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