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Volunteer Rape Crisis and Domestic Violence Advocate Application
Hi there! We're so glad you're interested in becoming a volunteer advocate with CVTC, and we appreciate the time you're taking to fill out this application. If you have any questions, please don't hesitate to contact Amy at (212) 523-9040 or aiwanowicz@cvtcnyc.org. Happy writing!
Part One: The Simple Stuff
First Name
Last Name
Mailing Address
Please be sure to add in your apt/unit number, as we will use this address to send you training supplies.
Street Address (including apartment/unit/suite #)
City
State
Zip Code
Country
Email
Mobile Phone Number
Home Phone Number
Work Phone Number
Date of Birth
Do you think of yourself as...
If other, specify:
What are your pronouns?
If your pronoun is other, specify:
Race/Ethnicity
Languages (other than English) that you speak:
Occupation
Employer and job title (if applicable)
Are you currently a college student?
If you are a student, kindly specify your school, field of study, and expected date of graduation:
Part Two: The Nitty-Gritty Stuff
Have you previously applied to be a volunteer with CVTC?
Will you be available to attend a training in-person in NYC this October?
Can you commit to being on call for two shifts per month?
If you are not available to volunteer in person, why not?
Can you get to Mount Sinai Morningside (114th & Amsterdam, Manhattan) within 20 minutes in a taxi?
Can you get to Mount Sinai West (59th St. & 10th Ave., Manhattan) within 20 minutes in a taxi?
Can you get to Northwell Greenwich Village Hospital (formerly Lenox Health) (13th St. & 7th Ave., Manhattan) within 20 minutes in a taxi?
Can you get to Brookdale Hospital (One Brookdale Plaza, Brooklyn) within 20 minutes in a taxi?
Can you get to NYU Langone-Brooklyn (150 55th Street, Brooklyn) within 20 minutes in a taxi?
As of October 2025, what borough will you be living in?
If accepted, are you able to commit to the program for at least one year?
Are you available to attend ALL five of the following training dates? (Check the boxes for "yes.")
1. Thursday, Oct 9 (6pm-9pm)
2. Saturday, Oct 11 (9am-5pm)
3. Sunday, Oct 12 (9am-5pm)
4. Saturday. Oct 18 (9am-5pm)
5. Sunday, Oct 19 (9am-5pm)
How did you discover CVTC's Volunteer Advocate Program?
Poster
Instagram
Online Search
Facebook
Twitter
From a friend
Other
Are you now, or have you ever been, a CVTC client?
Volunteers are required to be vaccinated against COVID-19. Have you received the COVID-19 vaccine?
Do you have any accessibility needs?
If you do have accessibility needs, please describe them briefly here:
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Part Three: Getting to Know You More
Why do you want to be a volunteer rape crisis and domestic violence advocate in the emergency department?
What personality traits do you possess that you believe will help you be a good crisis counselor and advocate?
Do you have any previous experience or special skills that might be relevant to helping survivors of rape and domestic violence?
Please note any previous training on sexual assault, domestic violence, or crisis intervention, including workshops, conferences, or courses you've completed:
Does being an advocate fit into your personal and/or career goals? If so, how?
What are your concerns, fears, and questions about becoming an advocate?
Is there any additional information you wish to share with us at this time?
References
Please provide us with the name and telephone number of a professional or educational reference, such as a current or former supervisor, professor, or teacher. For reasons we hope are clear, please do not use a family member or friend.
Reference Name:
Daytime Phone
Relationship to you:
Please upload a dashing photo of yourself (but don't stress, it's for internal purposes only.)
Photo