| Back When you know that you would like to volunteer with the Rape Crisis Center, please send in the following Volunteer Information Form. After receiving your form, someone will contact you to set up a time to meet with you prior to your participation in the next training session. | |
RAPE CRISIS CENTER | |
| Administration Phone Number 608-251-5126 Crisis Line/Services 608-251-7273 | |
| Fax Number 608-251-6229 | |
| Please return this form to: Crisis Service Coordinator, Rape Crisis Center, 128 E. Olin Avenue, Suite. 202, Madison, WI., 53713. | |
| NAME:___________________________________ DATE:______________ | |
| STREET ADDRESS:_____________________________________________ | |
| CITY:______________________________________ ZIP:____________ | |
| PHONES: home)__________________ work)__________________ | |
| EMAIL:________________________________________________ | |
1. Are you a UW-Madison student?  Yes No | |
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| 2. How did you hear about volunteering at the Rape Crisis Center? | |
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| 3. Please select the one volunteer opportunity for which you would like to train at this time: | |
| Crisis Line Counselor | |
| Special Projects Volunteer | |
| 4. Why are you interested in volunteering at the Rape Crisis Center? | |
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| 5. Do you have any paid or volunteer experiences, education or life experiences that may apply to your volunteer work at the Rape Crisis Center? Please describe. | |
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| 6. Have you ever been a client of the Rape Crisis Center? Yes No If yes, when? | |
| 7. Will you be available to volunteer during June, July, and August? Yes No
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| 8. The Rape Crisis Center has adopted an Affirmative Action Policy in compliance with Federal Law. In an attempt to judge the effectiveness of our recruitment efforts, we request the following information. This information will not be used, in any way, regarding decisions to become or continue to volunteer at the Rape Crisis Center. | |
| Sex___________ Veteran Status___________ Race__________________ | |