VIBS Family Violence and Rape Crisis Center
Victims Information Bureau of Suffolk

P.O. Box 428
Holbrook, NY 11741
(631) 360-3730

General Volunteer Application

Name: *
Date:
Address: *
Daytime Phone: *
Evening Phone: *
Email Address: *

1. Why do you want to volunteer for VIBS?

2. Have you volunteered for another agency? If so, where and what type of volunteer work did you perform?

3. What kind of special skills or abilities can you offer to VIBS (e.g. languages spoken, computer literacy, etc...)?

4. What type of volunteer work are you interested in (e.g. structured play with clients children, general office work, special projects)?

5. When are you available? Please indicate whether you are looking for short or long term projects.

Do you have access to a reliable car?

7. Employment background

8. Educational background

Please list a person to contact in case of emergency

Name:
Phone:

Please list the name(s) of anyone else you know who may be interested in volunteering

Please read the following statement, when you come to VIBS you will be asked to sign a printout of this form (note: all prospective volunteers must sign the pledge in order to be admitted into the program).

Victims Information Bureau of Suffolk operates from a position of respect for all of our clients, staff and volunteers regardless of: race, sexual orientation, ethnicity, religion, ability, age or gender. Any volunteer who shows intolerance to diversity will be immediately dismissed from the program.