CAT APPLICATION
New Britain Sexual Assault Crisis Service
What: A 40-hour training program
leading to certification as a volunteer Sexual
Assault Crisis Counselor. No prior
experience or knowledge of sexual assault is needed to apply for the
class. A fee of $50 is required to
cover costs of training materials for the class and is dependent upon volunteer
commitment. (A fee of $200 is required
for persons taking the class for professional development purposes only.)
Volunteers will provide supportive counseling and advocacy to sexual
assault survivors and their families through hotline calls and hospital VISITS. Volunteers will be required to be on call
for at least three shifts a month, for a commitment of one year. To maintain certification, volunteers must
attend four hours of inservice training per year and attend annual supervision.
Who: Anyone interested in providing hotline
counseling, and assisting survivors and families at hospitals on a voluntary
basis, can apply for the class.
Volunteer’s can also become involved in support group facilitation,
community education, one-to-one counseling (in person), legislative lobbying,
special projects, and fundraising.
Where: New Britain YWCA
When: We
run a Fall and Spring course
Questions? Contact Elena Morosky 225-4681 ext. 211
Dear
Training Candidate:
Welcome
to the YWCA of New Britain Sexual Assault Crisis Service Counselor Advocate
Training Program. We are excited that
you have expressed an interest in joining our team and look forward to working
with you in the effort to end sexual violence and support sexual assault
survivors, their families and friends.
In order for us to prepare
for this program, we ask that you review the enclosed information, complete
the necessary forms and return them to us. These forms, along with a pre-training interview, will assist us
in assuring that your interest coincides with our needs. Interviews will be scheduled once your
paperwork has been received.
If other considerations are needed let us know.
The fee for this
training is set up as follows: $50 with a one-year volunteer commitment, and
$200 if you are taking the class for professional development. All fees are payable the first week of class
and are non-refundable.
If you have any
questions regarding the training, the enclosed paperwork, or fee arrangements,
please contact, Elena at 225-4681 ext. 211. We look forward to meeting you.
Sincerely,
Elena
Moroksy
Coordinator
SEXUAL ASSUALT CRISIS SERVICE
YWCA
SEXUAL ASSAULT CRISIS SERVICE (SACS)
VOLUNTEER
APPLICATION
VOLUNTEER
DISCLAIMER
I understand that the following volunteer intake
is voluntary. The purpose for engaging
in the volunteer intake is to facilitate the volunteer training process at the
New Britain YWCA Sexual Assault Crisis Service (SACS). Should I decide not to engage in the
volunteer intake, I understand that SACS may not have enough information about
my abilities as a volunteer to accept me into the volunteer training.
__________________________________________ __________________________ Signed Date
INTAKE
QUESTIONNAIRE
CITY_______________________________
ZIP CODE_________________________
GENDER: ____FEMALE ____MALE
Please note: The following questions ask for
personal information that is important to helping us provide high quality
services to our clients. All answers
will remain confidential; no one outside the agency will be given this
information without your permission. A
lack of experience, or of knowledge of any topics discussed in this
questionnaire does not disqualify you from becoming part of the class. Please answer the questions honestly and
completely.
1. Why
are you interested in becoming a volunteer for SACS?
2. What
do you think are qualities that make a good volunteer for SACS?
3. Have
you had any volunteer experience in the past?
If yes, where did you volunteer and what did you do there. How long were you a volunteer there, and
what were some good and bad qualities about volunteering there?
4. What
strengths do you have that you could bring to our program?
5. What
do you feel your weaknesses as a volunteer might be?
6. Describe any experience you have in the following areas: counseling, rape crisis, facilitating groups, hotline coverage, crisis intervention, medical and legal issues, or public speaking.
7. What
is your understanding of sexual assault?
8. Do you speak any languages other than
English?
9. Your Volunteer Commitment will be for one
year. Do you have any questions or
concerns regarding this?
10. Have
you ever been convicted of a crime? If
yes please provide an explanation.
REFERENCE
PERMISSION FORM
Due to the confidential information that SACS
counselors handle, we ask that you allow SACS to contact two (2) references who
have known you for longer than one year, and are not related to you. One reference should be an employer, past or
present.
REFERENCE #1:
Name: _______________________________ Job Title: ___________________
Telephone numbers: ___________________________ Best time to call:
____________
How do you know this person?
_____________________________________________
How long have you known this person?
______________________________________
REFERENCE #2:
Name: _______________________________ Job Title: ___________________
Telephone numbers: ___________________________ Best time to call: ____________
How do you know this person?
_____________________________________________
How long have you known this person? ______________________________________
I,
___________________________,
give permission for the YWCA Sexual Assault
(Print name)
Crisis Service to contact the above people. I understand that this information will be
used to help determine my appropriateness as a SACS volunteer/counselor and
will remain confidential.
Signed:
___________________________________
Date: _______________________