Name

Email Address

Message

Social Media platforms I am currently on (check all that apply) Social Media platforms I am currently on (check all that apply) Facebook Instagram Twitter

If you checked any boxes above, please provide your @username (for each)

Interest & Skills (check all that apply) Interest & Skills (check all that apply) Event Planning & Fundraising Photography / Videography Social / Digital Media Web Design, Coordination or Maintenance PR Awareness Building Graphic Design (brochures, flyers, newsletter, online infographics, etc) Administrative (envelope stuffing, computer work, etc) Database Coordinator Crowdfunding; On-line Fundraising Corporate or Foundation Fundraising Grant Writer Policy Writer Other

Tell us about your experience, training, and skills in the areas checked, above:

Are you Interested in... Are you Interested in... Short Term Opportunities Long Term Opportunities

# of Hours Available per Week

Which Days/Months?

If you’d like to intern during the summer, would you need a place to stay? If you’d like to intern during the summer, would you need a place to stay? Yes No

How did you hear about Reviving Hearts//Renewing Dreams?

Where/when did you learn about human trafficking/sexual exploitation?

Why are you interested in volunteering?

Previous Volunteer Experience? (describe, include dates)

Job Experience? (describe, include dates)

Reference ( Name, Relationship, Phone, Email - not family members)

Reference: ( Name, Relationship, Phone, Email - not family members)

Criminal History: Have you ever been convicted of, pled guilty to, or pled no contest to a felony or misdemeanor? Criminal History: Have you ever been convicted of, pled guilty to, or pled no contest to a felony or misdemeanor? Yes No