Volunteer/Intern Application Form

Asian Task Force Against Domestic Violence
VOLUNTEER/ INTERN APPLICATION FORM

Before you complete this form, please read the following requirements for volunteers.
• Preserve our clients’ confidentiality as well as the location of the shelter and safe home.
• Commit to a minimum of 12-months or one academic year for direct services/program work, and a six-months or one-semester minimum commitment for indirect services such as office work.
• Attend the agency orientation.
• Participate in a 36-hours training for direct services volunteers and a 16-hours training for indirect services volunteers.
• Consent to a Criminal Offender Record Information check, tuberculosis test, and Hepatitis B immunization record for direct services volunteers.
• Attend a monthly supervision meeting for shelter volunteers.

Name

Address

Address2

City

State/Province

Zip/Postal Code

Contact Phone Number

Home Work Cell

Birthday

Month Date

The volunteer/intern job descriptions are posted on our website, www.atask.org.
Please check all positions that interest you.

Volunteer
Shelter
Hotline
Children’s Program
English Tutoring (adults)
Computer Tutoring (adults)
Administrative

Special Skills:

	graphic/web design
	IT consulting
	self-defense
	dance
	haircut
	make-up
	carpentry
	arts & crafts
	wellness (yoga, aroma therapy, acupuncture, other )

Other (please specify):

Intern
Marketing/Communications
Finance
Project SAFE (Outreach & Education)
Administrative
Shelter
Lowell Advocacy Assistant

Please indicate your availability (days and hours). Keep in mind that we ask for a minimum of three hours per week. Note: We seek interns/volunteers to assist 9:00 am – 8:00 pm from Monday to Friday at the shelter & 10:00 am – 5:00 pm from Monday to Friday at the office.

If you have a car, are you willing to use it in your volunteer work with us?
Yes No I do not have a car

How did you hear about the Asian Task Force Against Domestic Violence?

What attracted you to this opportunity?

Please indicate your non-English language capacity. Note your fluency – basic, intermediate, advanced, or native speaker – for languages other than English. If not applicable, please go to the next question.

Language	Speaking	Listening	Reading/Writing

List all of your volunteer experience. Include dates of service, volunteer title/duties, and organization.

What would make this volunteer experience rewarding for you? What are you hoping to gain from this volunteer experience?

The following questions help the volunteer coordinator determine the most appropriate placement for volunteers and interns. If you are uncomfortable answering these questions, please note that you would to discuss your answers with the volunteer coordinator.

Do you have any education or work experience related to domestic violence? If so, please tell us about it.
(This question is optional.)

Have you ever had any personal experience with domestic violence?

Why do you think some people stay in a domestic violence situation?

Do you feel comfortable working with individuals from a different culture/race/ethnicity/sexual orientation than your own? Have you ever worked or lived in a multicultural/diverse environment? Please describe your experience.

Please use this space if you have additional comments.

Please provide two professional references.

	Reference 1	Reference 2
Reference name
Reference phone number
Reference email address
Relationship to you

Attach Resume:

Please attach your resume to this completed application and send via postal mail, fax, or email to:
Koko Oyama, Direct Services Coordinator
ATFADV
P.O. BOX 120108
Boston, MA 02112
Phone: 617-338-2352 x227
Fax: 617-338-2362
Email: hiroko@atask.org
THANK YOU FOR YOUR INTEREST!

To mail or fax an application, please print out the following form and submit to:

print version/PDF

Koko Oyama
ATFADV
P.O. Box 120108
Boston, MA 02112
Fax: (617) 338-2354

Home • Need Help? • About Us • Get Involved • Events Asian Task Force Against Domestic Violence • PO Box 120108 • Boston, MA 02112 Hotline: 617.338.2355 • Tel: 617.338.2350 • Fax: 617.338.2354 • Email: asiandv@atask.org Copyright © Asian Task Force Against Domestic Violence. All Rights Reserved.