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If you would like to apply to be a volunteer online, please fill out the form below. If you would like to print out an application form and mail/fax it to us, please click here. Make sure to view our privacy policy if you have any reservations about providing information to us via the online form.

Online Application
Section 1: Personal Information
Surname:	Given Names:
Home Phone:	Alt.Phone:
Email Address:
Home Address:	Town/City:
Province:	Postal Code:
How long have you lived at this address?:
Are you over 19?	YES NO
Are you a Canadian citizen?	YES NO
Are you a landed immigrant?	YES NO
Do you possess a valid driver's license?	YES NO
Do you have six or less demerit points?	YES NO
Driver's License Number:
Do you have a vehicle?	YES NO
Would you be willing to use it with Victim Services?	YES NO
License Plate Number:
Have you been convicted of any criminal offense for which a pardon has not been granted? (This would include any fine, period of imprisonment or period of probation ordered by a court)	YES NO
Please explain the circumstance:
Languages Spoken:
Languages Written:
Section 2: Education, Credentials, Involvement
Secondary School - Highest Level Achieved:
Type of Secondary School Diploma Received:
College/University Diploma/Certificate/Degree:
Business/Trade/Technical/Apprenticeship Programs:
Workshops/Seminars/Extra Courses:
Life Experience Education:
Special Skills (CPR, Computers, etc.)
Volunteer Work & Length of Service
Organizations, Civic Groups
Hobbies, Recreational Activities
Can you commit to a minimum of one year's service?	YES NO
Two 12 hour shifts plus one meeting a month?	YES NO
Section 3: Employment History
Present or Last Employer:
Telephone Number:
Date of Employment:
Mailing Address:
Supervisor's Name & Title
Your Position/Duties:
Reason For Leaving:
May we contact this reference?	YES NO
Section 3.5: Employment History - If above less than 5 years
Previous Employer:
Telephone Number:
Date of Employment
Mailing Address:
Supervisor's Name & Title
Your Position/Duties:
Reason For Leaving:
May we contact this reference?	YES NO
Section 4: Victim Service Volunteering
Can you commit to the lengthy training process?	YES NO
Can you commit to the ongoing training provided?	YES NO
Times Available for on-call: (select all that apply)	Daytime Overnights Weekdays Weekends
Please describe your perception of what P/N Victim Services does:
Section 4.5: References - Non relative (2) plus Professional (2)
Name:
Address:
Phone:
Email:
Relationship:
Name:
Address:
Phone:
Email:
Relationship:
Name:
Address:
Phone:
Email:
Relationship:
Name:
Address:
Phone:
Email:
Relationship:
Volunteer Position Requirements Ability to maintain strict confidentiality of all issues surrounding calls for service to victims, information shared in volunteer training sessions and information about the organization. Mature and Responsible Good written and verbal communication skills Ability to deal effectively with crisis situations Ability to commit to one year's service Willing to submit personal references, provide a criminal background check, attend an interview with PNVS Suitability to provide sensitive, emotionally safe, and effective service to victims on behalf of PNVS Knowledge of community resources Knowledge of law, as pertaining to victims Own transportation a preference Willing to complete minimum standard's training, examination, ongoing meetings and educational development. Ability to work as part of a crisis team.
Position Summary After successful completion of the standardized volunteer training, passing the examination requirements, swearing an oath of confidentiality and orientation, potential volunteers may be qualified as a victim service provider with Peterborough/Northumberland Victim Services. Once qualified, the volunteer, always working as part of a crisis team, will respond immediately to requests from Police and Fire Personnel to provide short-term emotional support and practical assistance to victims of crime, tragic circumstance or disaster. The volunteer will ensure that appropriate options and/or referrals for longer-term assistance are provided to the victim.
Direct Service Responsibilities Respond immediately to requests for victim assistance from police officers by attending onsite or an alternate safe place. On occasion, crisis assistance may be done by telephone. Provide emotional support and companionship, which empowers the victim, including answering questions and providing information that will help lessen the impact of the crisis for the victim. Provide practical assistance as needed. This may include transportation, and/or accompanying a victim to emergency services (ex: shelter, hospital, etc.), making telephone calls on request, or alternate arrangements as required, helping to secure premises and other similar tasks. Identify longer term needs by responding to the victim's concerns and supply the victim with appropriate options and referrals to services in the community that will assist them in accessing resources for further assistance. Reporting to the Team Leader (or other designate) upon arrival, upon completion and upon arriving back home. Participating in the evaluation of the call and providing relevant information to the Program Coordinator for client follow-up
Other Duties and Responsibilities Ongoing participation in monthly training meetings and any other volunteer training events as scheduled. Reporting back to the Program Coordinator, or designate, if a victim assistance call or assignment is particularly stressful for the attending volunteer(s). Individual debriefing will be available to assist the volunteer(s) in coping. Bringing to the Executive Director's attention any inappropriate volunteer behaviour or victim complaint that could adversely affect the Peterborough/Northumberland Victim Services program. Ensuring that the pager is working Completion of expense statement for mileage and out-of-pocket expenses Complete an annual self-evaluation and review it with the Program Coordinator.
Please note: Acceptance into the training does not guarantee that an applicant will be involved in direct service provision to victims. All staff, volunteers and board will be subject to a criminal background and CAS check. References will be checked as part of the evaluation process. An applicant's employment or educational background may be subject to verification. Any association with a person or persons engaged in criminal activities will result in termination from the program.
Confidentiality Agreement In the course of being a volunteer with Peterborough/Northumberland Victim Services, you will have access to information that must remain confidential. Breach of confidentiality will result in termination of your association with Peterborough/Northumberland Victim Services. Your signature below indicates your understanding and acceptance of this obligation.
(On line applications: Please type name, you will be asked to sign application at your interview.) Name:   Date: