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P.O Box 17996
Richmond, VA 23226
Office: 804-249-9470
Fax: 804-249-9472
Safe Harbor is a
501(c) 3 Organization

  
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Stop the violence. End the silence.

Mission: Safe Harbor saves lives by providing education, advocacy, counseling & shelter to break the cycle of domestic violence.

Volunteer Application

Date:
Name:
Address:
City:
State:
Zip:
E-mail:
Home Phone:
Work Phone:
Occupation:
Employer:
Are you over 18?	Yes No
Education (check one):
Some High School From Dates: Some College From Dates: College Degree From Dates: Advanced Degree From Dates:
Volunteer Interests (Check all that apply):
Child Care: Watch children while their mother meets with the counselor or case manager or attends interviews. Daytime or some evening hours. Donation Assistant: Inventory and put away donations. Hours flexible. Speakers Bureau: Outgoing individuals willing to learn domestic violence materials for giving training sessions to groups. Also staff booths and information tables at community events. Variable times and days. Court Advocate: Assist and accompany clients seeking protective orders. This is a supportive presence, not legal assistance. Requires daytime hours. Relief Workers: Answer hotline and door, interact with clients, take care of needs that arise, and do intake on new clients. This position covers the house in absence of staff. Training given until fully comfortable with the position and staff are always on call. Flexible hours. Other
Why do you want to volunteer with Safe Harbor?
How did you hear about Safe Harbor?
Please list current or previous volunteer work:
What previous experience do you have working with people in crisis/stressful situations?
Please list any additional knowledge, skill, or experiences which would benefit Safe Harbor:
When are you available? Please check all that apply:
Monday Morning Monday Afternoon Monday Evening Tuesday Morning Tuesday Afternoon Tuesday Evening Wednesday Morning Wednesday Afternoon Wednesday Evening Thursday Morning Thursday Afternoon Thursday Evening Friday Morning Friday Afternoon Friday Evening Saturday Morning Saturday Afternoon Saturday Evening Sunday Morning Sunday Afternoon Sunday Evening
All applicants will be interviewed and will be required to go through training.
Please list three references. Do NOT include family or spouse.
Name: Home Phone: Work Phone: Email: Name: Home Phone: Work Phone: Email: Name: Home Phone: Work Phone: Email:
Thank you and please allow 5 business days in order to respond to your application.