Volunteer Application
Mission Statement: The purpose of the Center for Hope & Safety is to provide a safe environment for survivors of domestic violence, sexual assault, stalking, and human trafficking and to educate the public about the issues surrounding victimization. Individuals representing a cross-section of the community will join together to operate programs that respond directly to needs identified by survivors of violence. Our agency philosophy will reflect the survivors' right to receive information about abuse and their right to make their own choices from a wide range of options. 

The Center for Hope & Safety is located in Salem Oregon and serves Marion County and surrounding areas. 
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Email *
First Name *
Last Name *
Pronouns (if you feel comfortable and would like to share)
Full Mailing Address (Street Address, City, Zip Code) *
City, State, Zip Code of your residence  *
Cell Phone Number *
Secondary Contact Number (optional)
Preferred Method of Contact (Please note: Initial contact and scheduling of meetings of any kind will be done via email) *
Required
Occupation *
Workplace *
Emergency Contact Name (Purpose: ) *
Emergency Contact Number *
Emergency Contact Relationship *
How did you hear about CHS? *
Demographic Information (optional)
The following sections contain demographic information that our grant reports ask for and having the information is helpful in securing the funding we need to support survivors. All information is reported to grant funders anonymously. If you feel comfortable sharing, please indicate if you identify with any of the following groups and identities.
Gender Identity:
Feel free to check all that apply (listed in alphabetical order):
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