SUICIDE PREVENTION PARTNERSHIP (SPP)
WELCOME. Thank you for your interest in volunteering at Suicide Prevention Partnership. For screening purposes, please complete the following:
Name Date
Local Address
Permanent Address
Phone #1__________ H W C Phone#2__ ___ _ H W C
Phone #3_____ __ H W C
Occupation _____________
Date of Birth ____ __
Social Security# _________________________
E-mail address________
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Your level of education___ ________ __Area of concentration___________________
Are you currently a student? Yes No If yes, school? _____________________
Status? Fr So Jr Sr Grad
How long do you expect to be in the El Paso County area?
____ ____________ ________
Will you be available to work:
Holiday break 2010? yes no part of it_
Summer Break 2011? yes no part of it
What experience have you had working with people (eg. jobs, volunteer work, groups, trainings, etc.)?
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Please list any current or past community involvements (e.g. clubs, organizations, volunteer activities, etc.)
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We generally ask for a commitment of an average of 4 hours per week for one year. Can you make this commitment? Yes No If no, what commitment would you be able to make in terms of hours per week and length of time?
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Do you intend to work with us as part of an undergraduate or graduate school practicum? yes no If yes, what school and program?
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How did you hear about Suicide Prevention Partnership?
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What has led you to apply to SPP’s training program?
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What difficulties, if any, do you think you might encounter working at an agency where a nonjudgemental attitude is required?
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Have you checked your schedule to make sure you can attend ALL training sessions?
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What other information, if any, do you wish to provide?
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We ask for a contribution of $20.00 to help defray the cost of training supplies. This is paid upon acceptance to the training program. Thank you for your time and interest.
Suicide Prevention Partnership (SPP) reserves the right to screen potential volunteers/counselors. Completion of this application does not guarantee the applicant a volunteer position at SPP. SPP does not discriminate on the basis of age, sex, race, religion, ethnicity, sexual orientation, or disability.