Abuse and Rape Crisis Shelter of Warren County

If you would like to volunteer for ARCS please print and complete the following application.  Mail to:  ARCS Volunteer Program, 27 N. East St., Lebanon, Ohio 45036.  For more information please call 513-695-1185 or email:  acrisisshelter@cinci.rr.com

Name:  ______________________________________________   SSN: ___________________

Address:  ______________________________________________________________________

Phone:  (H) _____________  (W) _____________  (C) _____________  Fax _______________

Email address:  _________________________________________________________________

Employer:  ____________________________________________  Hours:  _________________

Address:  ______________________________________________________________________

Job Title:  _____________________________________  May we call you at work? __________

1.  How did you hear about the Abuse and Rape Crisis Shelter (ARCS)? __________________

     ___________________________________________________________________________

2.  Why did you select ARCS as a place you would like to volunteer?  ____________________

     ___________________________________________________________________________

3.  What education, experience, skills and interest would you bring to this 

      volunteering position?  ________________________________________________________

      ___________________________________________________________________________

4.  Are there areas in which you are especially interested in receiving training? _____________

5.  What is your personal preference in volunteering?

       _____   Working directly with client

       _____   Working with children

       _____   Working indirectly through non-client activities (e.g. donations 

                   sorting, pick up, office work, or shelter/grounds care, etc.)

      _____    No preference, would do both direct and indirect services

6.   Have you worked with victims of domestic violence and/or rape, either

      directly or indirectly?  If so, please explain _______________________________________

        _________________________________________________________________________ 

7.   Why do you want to work with domestic violence/rape victims?  ______________________

       __________________________________________________________________________ 

8.   Have you ever had any personal experience with domestic violence or sexual assault either

      as a victim or has someone in your immediate family suffered abuse?  Please explain

      ___________________________________________________________________________

      ___________________________________________________________________________

9.   Have you experienced any direct abuse in the past year?  ___________________________

10.  As a protection for clients and to satisfy Agency insurers, ARCS routinely does

      background and fingerprint checks on the staff it employs and the individuals who

      volunteer.  Do you grant ARCS permission to do background checks with the police

      department, Children's Services and the references you provided? ________   If no,

      please explain:  _____________________________________________________________

      ___________________________________________________________________________

11.  Please provide at least three references below with two references from a Supervisor 

      Employer, or Spiritual Leader etc).  One reference may be a personal reference (i.e. a

      friend or family member).  We MUST have complete mailing addresses.

      Name:   ___________________________________________________________________

      Address:___________________________________________________________________

      City, State, ZIP: _____________________________________________________________

      Telephone:  (H)   ____________________________  (W)  ___________________________

      Relationship:  _______________________________________________________________

      Name:   ___________________________________________________________________

      Address:___________________________________________________________________

      City, State, ZIP: _____________________________________________________________

      Telephone:  (H)   ____________________________  (W)  ___________________________

      Relationship:  _______________________________________________________________

      Name:   ___________________________________________________________________

      Address:___________________________________________________________________

      City, State, ZIP: _____________________________________________________________  

      Telephone:  (H)   ____________________________  (W)  ___________________________

      Relationship:  _______________________________________________________________

12.  Liability insurance requires that we do an Ohio Bureau of Motor Vehicle check.  This

      information is necessary in order to comply with their requirements.

      Date of Birth ____________________________   Driver's License Number ____________________________ 

       Automobile Insurer  _______________________________________________________________________ 

13.  Please list hours and days available during the week.  Remember:  ARCS is open seven

      days; 24 hours a day.   _______________________________________________________

14.  There are areas in which you can volunteer without first attending training.  Mark any of

       the following areas for which you would be interested in volunteering after your volunteer

       interview meeting but before volunteer training.

_____   Office help (computer, typing cards, filing, phone calls, bulk mailing, newsletter, etc.)

_____   Donations (pick-up/sort/organize/Shared Harvest pickup/pantry)

_____   Grounds (plant flowers, do trimming, shovel snow, salt sidewalks, etc.)

_____   Shelter (cleaning, organize closets, grocery shopping, etc.)

_____   Shelter maintenance/light repair

_____   Supervise family activities

_____   Child care (chaperoning, assist with children's program, etc.)

_____   Child activity (sort and wash toys, do prep work such as magazine cutting, etc.)

_____   Fund Raising

_____   Computer Data Entry, if yes list programs ____________________________________

_____   Other:  _________________________________________________________________

15.  Direct service to clients will require you to attend a 30 to 40 hour in-service training. 

      These trainings are conducted two times a year, usually in February and late September.

      If you are interested in direct client services, please indicate which volunteer areas you

      would be interested in.

After Training Volunteer Opportunities

_____   Shelter Coverage (taking crisis calls, intake clients, discuss issues with clients, 

            transport to appointments, etc.)

_____   Providing "follow-up" support and assistance to ex-clients who have left their abuser

_____   Advocacy (taking clients to legal aid, attorney, court, do court monitoring, taking

            clients to the hospital, etc.)

_____   Conduct children's group sessions

_____   Conduct "Life Skills" classes

_____   Rape Crisis "On Call"/Advocacy                 

_____   Rape Crisis "Hot Line" / Domestic Violence Crisis Calls

_____   Other:  _________________________________________________________________

I have completed this application honestly and to the best of my ability.  I understand that I will meet with ARCS staff to discuss my volunteering and if mutually agreeable, will either begin to volunteer or will be scheduled for training.  I will promise to keep confidential all client information, as well as, the location of the Shelter.

Signature:  _________________________________________    Date:  __________________