subject_line
Volunteer Program Application
First Name
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Last Name
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Email Address
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Phone Number
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May we leave a voicemail at this number?
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Yes
No
Street Address
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City
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State
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Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
Zip Code
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Twitter Handle
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How did you hear about Casa Myrna?
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What type of volunteer opportunities are you interested in?
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Direct Service
Program Engagement
Special Projects
If you're interested in Direct Service volunteer opportunities, what type of advocacy work are you interested in doing?
SafeLink Hotline Advocacy
Residential Support Advocacy
What times are you available to volunteer? Please check all that apply.
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Weekday Mornings
Weekday Afternoons
Weekday Evenings
Weekend Mornings
Weekend Afternoons
Weekend Evenings
Casa Myrna requires all Direct Service volunteers to attend a 35-hour domestic violence training. Are you able to complete the full training at this time?
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Yes
No
Not Sure
Some volunteer opportunities require a commitment of at least one year. Are you able to make one-year commitment at this time?
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Yes
No
What are some of your special skills?
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Advocacy
Event Planning
Working with Children
Workshop Facilitation
Public Speaking
Web/Graphic Design
Blogging/Writing
Video
Other
Other
Why are you interested in volunteering with Casa Myrna?
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Please tell us how often and for how long you're available to volunteer with Casa Myrna.
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How would you define domestic violence?
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Please describe your experience working with survivors of domestic violence.
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What type of skills or interests do you have that would be beneficial to Casa Myrna and our clients?
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If you're interested in the Special Projects volunteer opportunity, what type of projects are you able to undertake for Casa Myrna at this time?
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If you're interested in the Program Engagement volunteer oppportunity, please describe what types of events/activities/workshops you are interested in providing for Casa Myrna.
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How would you describe your ability to handle conflict and deal with complex situations?
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Do you have any concerns or questions about volunteering with Casa Myrna?
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Please provide any additional information you'd like us to know about you or your background.
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