Volunteer Application

Eastland County Crisis Center

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ECCC Volunteer Application

* Indicates required field

Name *

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Last

Email *

Phone Number *

Address *

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City

State

Zip Code

Country

The Eastland County Crisis requires successful completion of a criminal background check, a DFPS background check, and a sex offender registry check. In addition, all volunteers must complete a basic orientation training prior to serving.

If you are accepted, are you willing to submit to the necessary background and registry checks AND commit to the necessary training? *

Employer *

Can you contact you at work? *

Work Phone Number *

I am interested in: (Check all that apply) *

Hotline/Direct Services Fundraising Office Work Education Community Outreach

I am available: (Check all that apply) *

Weekdays (8am-5pm) Evenings (5pm-8am) Weekends (Sat.- Sun) Various times

How many days a month would you like to volunteer? *

Please check all that apply: *

I am currently on probation/parole I am seeking community service hours I have been arrested, charged, or convicted of a crime I have beliefs that would limit my ability to work with victims of domestic violence or sexual assault. None- These do not apply to me.

Please explain (unless you checked "None"): *

volunteer experience

Do you have any training on Domestic Violence, Sexual Assault, and/or Child Abuse? *

Please list all present or past volunteer experiences:

Do you have any experience working with victims of Domestic Violence, Sexual Assault, and/or Child Abuse? *

Program/Agency *

Supervisor Name *

First

Last

Supervisor Contact Information (Phone or Email) *

Program/Agency *

Supervisor Name *

First

Last

Supervisor Contact Information (Phone or Email) *

Program/Agency *

Supervisor Name *

First

Last

Supervisor Contact Information (Phone or Email) *

personal references:

Name *

First

Last

Phone Number *

Type of Reference *

Select One *

Years Known: *

Name *

First

Last

Phone Number *

How did you learn about our program *

Submit

ECCC 24/7 CRISIS HOTLINE
(24 Hour Crisis Hotline for survivors of sexual violence to provide immediate, confidential, non-judgmental support, crisis intervention,
information and referrals)

254 629 3223 (TTY#)

888 686 3222 (TTY#/Toll Free)

show your support

Invest in the healing of domestic violence, sexual assault, and child abuse victims

Invest in a brighter tomorrow

ECCC Volunteer Application

volunteer experience

personal references:

ECCC 24/7 CRISIS HOTLINE(24 Hour Crisis Hotline for survivors of sexual violence to provide immediate, confidential, non-judgmental support, crisis intervention,information and referrals)

show your support

ECCC 24/7 CRISIS HOTLINE
(24 Hour Crisis Hotline for survivors of sexual violence to provide immediate, confidential, non-judgmental support, crisis intervention,
information and referrals)