Volunteer/Intern Application
Thank you for your interest in volunteering with Alianza DV Services, Inc. Please complete and submit this form. (You may also print and mail this form to Alianza - Development Office, P.O. Box 1099, Holyoke, MA 01040.)

Once your application is reviewed you will be matched with a volunteer or intern job or task.  A staff member will contact you to set up an interview. All information on this form will be kept confidential and will help us find the perfect volunteer role for you. Since Alianza serves a vulnerable population, we require criminal background checks for all staff and volunteers and we assist you with getting this done in a confidential and efficient way.

About Alianza:  We are a nonprofit organization working in Western Massachusetts to provide assistance, support, and empowerment for those who are affected by domestic and intimate partner abuse. We provide 24hr/day-7 day/week emergency Hotline, safety planning, emergency shelter, housing and medical advocacy, and assistance with court-based issues related to domestic violence. Our services are survivor-centered and provide the emotional support, empathy, and the space for survivors of domestic violence to tell their story.

Name *
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Street *
City, State, Zip Code *
Home Phone
Cell Phone *
Email *
Employer (if applicable) *
Age Range *
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Please indicate that you are willing to complete a CORI background check: *
Do you have any special skills you would like us to consider when placing you in a position? *
Please list any languages you speak fluently *
Current volunteer opportunities are below. Please check which jobs are of interest. *
Required
Which days are you available? *
Required
Please list any accommodations that you may need: *
School/College/University attending (if applicable): *
Major/course of study (if applicable): *
Advisor's Name and email or phone number (if applicable): *
What are the requirements the college/university has for the placement and placement supervisor? 
 *
Expected graduation date (if applicable): *
Desired semester for internship placement (if applicable):
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What type of internship credit are you seeking:
Please share specific goals you have for this internship:
Liability Release
As a volunteer of Alianza I agree to abide by all policies and procedures as spelled out in the volunteer handbook. I understand that I volunteer at my own risk and neither the organization nor its employees assume any liability for any accidental injury or health problem arising from volunteer work I perform for the organization. I agree that all work I do is on a volunteer basis and I am not eligible to receive any monetary payment or reward.
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