Volunteer Application

This online application will take you 15-30 minutes to complete. If you prefer to scan and email a completed application, download a printable version: Volunteer Application | Volunteer Release Form.

Step 1 of 7

General Information
First Name*
Last Name*
Preferred Name
Pronouns
- She/Her/Hers
- He/Him/His
- They/Them/Their
- Ze/Zir/Zirs
- Other, please list pronouns below
If listed other above, please provide preferred pronouns here
Home Address*
Street Address Apt # City State Zip
Phone Number*

Best number to contact you
Email*

Best email to contact you about your volunteer application
Are you 18 years of age or older?*
Hidden
Date of Birth*
Month
Day
Year
Is English Your First Language?*
Can you Speak Spanish?*
Do you speak any other languages? If so, please list here:

Please indicate level of fluency
Level of Education*
Institution Name of Highest Degree Earned
Education Status
Current Profession
Employer
How did you hear about Victim Service Center?*
Do you require any special accommodations?*
Emergency Contact Information
Contact Full Name*
Relationship to Volunteer*
Emergency Contact Home Address*
Street Address Address Line 2 City State Zip
Phone Number of Emergency Contact:*

Volunteer Opportunities
Please note that VSC does not allow volunteers to have direct client interaction at this time. All opportunities are indirect service to assist in building the capacity of the organization, or assisting the general public. Please check opportunities that you are interested in below. You may select as many as you like.
Advocacy Administrative Support/Front Desk
These opportunities assist the Advocacy Department in providing VSC services and information to clients. Only available during normal business hours, Monday-Friday from 8am-5pm. Ex: Filing paperwork, answering the front desk phone, assisting the Marketing/ Education Department with planning and development, confirming client intake appointments, creating client intake packets, answering the front desk phone, etc.
- Yes, I am interested in Advocacy Admin
Marketing & Events Assistant
These opportunities are during normal business hours, Monday-Friday from 8am-5pm. Assist non-direct care staff with projects and administrative work. Ex: researching sexual violence statistics, writing blogs, organizing in-kind donations, assisting the Marketing/ Education Department with planning and development, etc.
- Yes, I am interested in Marketing & Events Assistant
Outreach & Prevention
These opportunities are out in the community and involve working with community members and providing information and services to the general public. These events take place during the week, some evenings, and weekends. This opportunity is flexible and works well with all schedules. Ex: Conduct tabling events with advocates in the community, provide immediate support, offer information for services, etc. (Many tabling events require the set up/ break down of equipment and may entail standing indoors/outdoors for a long period of time).
- Yes, I am interested in Outreach & Prevention
Special Events
These opportunities involve assisting the Advocacy and Marketing Departments with the planning and/or execution of special events. Involves the planning and execution of events. Ex: Assisting advocacy and administrative staff with projects prior to, during, and/or after events, helping develop special projects, assistance with clerical tasks, etc.
- Yes, I am interested in Special Events
Share Your Story/ Speaker's Bureau
This position is specific for survivors of a crime or sexual violence. Volunteer will have the opportunity to share their personal story through the media, blogs, events, etc. The volunteers’ story may be anonymous.
- Yes, I'm interested in Speaker's Bureau

References

Please provide 2 references- (1) Academic/ Professional and (1) Personal
Name*
Relationship*
Organization & Title of Reference
Email*
Phone 1*
Personal Reference
Name*
Relationship*
Organization & Title of Reference
Email*
Phone 1*

Volunteer History

Have you ever been convicted of a felony or misdemeanor other than minor traffic violations, and/or been placed on probation, fined or given a suspended sentence in court? Include any convictions in military court and any criminal charges for which you are awaiting trial. List all cases other than minor traffic violations. (Driving under the influence, reckless driving or hit-and run ARE NOT MINOR traffic violations). Your fingerprints may at some point be sent to state and federal agencies and all service will be subject to satisfactory review of any criminal convictions.

PLEASE NOTE: A full disclosure by you is to your advantage as your record does not constitute an automatic bar to service. Factors such as but not limited to your age at the time of the offense(s), type of offense(s) as well as the relationship between the offense(s) and the job(s) for which you apply will be taken into account. However, failure to admit convictions will result in disqualification.
Does the above paragraph apply to you?*
- Yes
- No
If yes, please describe in detail
Have you ever had a criminal record sealed and/or expunged?*
- Yes
- No
If yes, please explain in detail

Volunteer Releases
Photo Release

The undersigned hereby consents to and authorizes the Victim Service Center of Central Florida (VSC), perpetually and exclusively to use and reproduce the undersigned’s name, voice, photograph, silhouette and/or all instrumental, musical and other sound effects taken and produced by the undersigned in connection with the production described herein, and to circulate and use the same for any and all purposes in any media now known or herein devised, including but not limited to publication and advertising of every description, including print media, motion pictures, radio, television and the Internet. Furthermore, the undersigned agrees that no advertisement or other material need be submitted to the undersigned for any further approval and VSC shall be without liability to the undersigned for any distortion or illusionary effect resulting from the publication of the undersigned’s photograph or likeness by the agency and by third parties out of the control of VSC. No further claim whatsoever arising out of, or connected with, said services shall be made by the undersigned or by the undersigned’s heirs, successors, licensees or assignees.
Initial
- I do not wish to release my photo.
Liability Waiver

This agreement releases Victim Service Center of Central Florida (VSC) from all liability relating to injuries that may occur during my volunteer assignment. By signing this agreement, I agree to hold VSC entirely free from any liability, including financial responsibility for injuries incurred, regardless of whether injuries are caused by negligence. I agree that I am participating voluntarily and that all risks have been made clear to me. Additionally, I do not have any conditions that will increase my likelihood of experiencing injuries while engaging in this activity. I will also make every effort to obey safety precautions as listed in writing and as explained to me verbally. I will ask for clarification when needed.
Initial*
Confidentiality of Services Provided

The rights and dignity of persons' served at the Victim Service Center (VSC) will be preserved at all times. There will be adequate space to accommodate privacy and confidentiality of persons' served during the intake procedures and counseling sessions. The purpose is to ensure that the VSC preserves the rights and dignity of the persons served at all times.

Confidentiality guarantees the person served the right to privacy. This means that any discussions about the person served, their records, or services shall remain private and confidential. The fact that an individual is a client must be kept private and any disclosure of information can only be made when authorized by the person served, statutes or court.
Initial*
Confidentiality Agreement
*
- As a volunteer of the Victim Service Center (VSC), I understand that I may have access to confidential information, both verbal and written, relating to clients, volunteers, staff and the organization. I understand and agree that all such information is to be treated confidentially and discussed only within the boundaries of my volunteer position at this organization.
- I agree not to discuss these same matters after I have left my volunteer position at this organization. I further understand that breach of this agreement shall constitute grounds for disciplinary action and may result in termination of my volunteer status with this organization.
- I agree that I will not take photos of clients, confidential details about clients or the organization, and confidential locations for personal use or distribution.
- VSC recognizes that volunteers may occasionally desire to use social media for personal activities while in the office. I understand that VSC authorizes such occasional use during rest breaks only, so long as it does not involve unprofessional or inappropriate content and does not interfere with my volunteering role. I also understand that I should not use VSC’s IT resources and communications systems for personal social media use or for any matter that I wish to be kept private or confidential.
- I understand that volunteering with VSC is contingent on a favorable level 2 background screening and does not guarantee volunteer placement.
Initial*
Discriminatory Clause
*
- VSC does not and shall not discriminate on the basis of race, color, religion (creed), gender, gender expression, age, national orientation, physical or mental disability, marital status, sexual orientation, or military status in any of its activities or operations. These activities include, but are not limited to employing and firing staff, selection of our volunteers and sponsors, and provision of services. I understand that VSC is committed to providing a welcoming environment for all members of our staff, clients, volunteers, etc. and will not discriminate on the basis of each category stated above.
Initial*
Acknowledgement
*
- I have read and understand the terms of the photo release, liability waiver, confidentiality of services provide, confidentiality agreement, and the discriminatory clause.
- I acknowledge that by signing below, this release will supersede and replace any and all other releases signed by me (whether previously or subsequently), or terms and conditions agreed to or specified by me, in connection with the above waivers.
Signature*

Volunteer Agreement

I certify that all the information contained in this application is correct and complete to the best of my knowledge. I understand that falsification of this application in any detail is grounds for disqualification for further consideration or dismissal from service. I hereby authorize investigation of all statements I have made herein. I authorize the persons or companies herein referenced to give information regarding my past employment, together with any information that they have regarding me, whether or not it is in their records. I hereby release said persons and companies from all liability for any damages whatsoever resulting from issuing or obtaining this information. Additionally, I am not currently serving on the governing entity and understand that no preferential treatment will be given in applying for the volunteer program. If a former Victim Service Center client, my case has been closed for at least one year. If selected to serve with the Victim Service center, I agree to comply by all its policies, procedures, rules and regulations.
Applicant's Name*
Applicant's Signature*

The Victim Service Center of Central Florida does not discriminate in recruiting, hiring, assignment, training, promotion or termination of staff and volunteers, selection of members of the governing board, nor the provision of services based on race, color, religion, disability, pregnancy, national origin, sexual orientation, sex/gender, gender identity, gender expression, genetic information, age, ethnicity, income, veteran status, marital status, or any other factor prohibited by federal, state or local laws, rules and regulations (collectively referred to as “Protected Status”).

This project was supported by Grant No. 2016-KF-AX-0045 awarded by the Office on Violence Against Women, U.S. Department of Justice. The opinions, findings, conclusions, and recommendations expressed in this publication/ program/exhibition are those of the author(s) and do not necessarily reflect the views of the Department of Justice, Office on Violence Against Women, the Department of Health, or the Florida Council Against Sexual Violence.

Volunteer Application

Step 1 of 7

General Information

Emergency Contact Information

Experience

Volunteer Opportunities

References

Personal Reference

Volunteer History

Volunteer Releases

Photo Release

Liability Waiver

Confidentiality of Services Provided

Confidentiality Agreement

Discriminatory Clause

Acknowledgement

Volunteer Agreement