MSU Sexual Assault Program

Volunteer Application

The sensitive nature of our work necessitates that we ask questions of a personal nature, which will be kept confidential. We need this information in order to make appropriate job assignments so you will have a rewarding volunteering experience and so we can accommodate special needs/concerns that you may have. In order to volunteer with our program, you will be required to complete the Sexual Assault Training Program and your application will be subject to a criminal background check.

Name: ______Today’s Date: _____/_____/______

Local Address:Date of Birth: _____/_____/______

______Phone Number:______

______Gender:______

Permanent Address (if different than above):E-mail address: ______

______Do you have a car? YES NO

______

Do you speak any languages in addition to English? YES NO

If yes, what? ______

Do you have any dietary restrictions (vegetarian, no dairy, etc.)? YES NO

If yes, what? ______

How did you hear about this training? ______

If you are a student, please answer the following questions: Student ID# _______

Major/Year: ______Anticipated Graduation Date: ______

Requirements to Volunteer:

  1. Complete Volunteer Application, Criminal Background Check, and MSU Student Conduct clearance (if affiliated)
  2. Attend mandatory 40-Hour Sexual Assault Crisis Intervention Training5-hour Medical Advocacy Training
    ALL TRAINING DATES MANDATORY!

  • Wednesday, Feb 7th from 6pm-10pm
  • Saturday, Feb 10th from 9am-5pm
  • Sunday, Feb 11th from 9am-5pm
  • MA Training: to be determined
  • Wednesday, Feb 21stfrom 6pm-10pm
  • Saturday, Feb 24th from 9am-5pm
  • Sunday, Feb 25thfrom 9am-5pm

  1. Attend mandatory volunteer meetings and in case of conflict by appointment with the Volunteer Coordinator
  2. Complete two shifts per month (either medical advocacy or crisis line) & one year commitment
  3. If you are a survivor of sexual assault, we ask that two years has elapsed since receiving services from the MSU Sexual Assault Program before applying to volunteer with our program.

MSU Sexual Assault Program (SAP) reserves the right to determine which services, if any, a volunteer may provide under the supervision of the MSU SAP. MSU SAP reserves the right to deny the opportunity to volunteer to any person at any time or dismiss them from the program at any time for any reason.

Please sign here to confirm you have read the volunteer requirements:

Why do you want to volunteer for the Sexual Assault Program?

What knowledge, skills, abilities or experiences working with a team do you possess that will help you contribute to our program?

Please describe any personal or professional experiences you have had dealing with sexual assault or relationship violence (family, friends, self):

Please describe your support systems and ways you manage stress:

What do you think will be the most challenging about volunteering with our program? The most rewarding?

How do you feel about outreach and public speaking?

In order to facilitate volunteer needs and arrange meaningful work assignments, we need to know if you have any disabilities or differencesthat we should be aware. Do you have any disabilities or differences that require special accommodations? YES NO If yes, please describe:

Submission Instructions

Please submit completed applications by mail or in-person to either address below:

MSU Sexual Assault Program

207 Student Services Building

East Lansing, MI 48824

To submit by fax, please fax your completed application to 517-353-8912.

To submit by e-mail, please save your completed application to your computer and e-mail the attachment to

APPLICATIONS DUE Friday, January 26th

Informational meeting about volunteer and internship opportunities on

Wednesday, January 24that 5pm in Room 6 Student Services Building

Questions? Please contact us!

Office phone: 517-355-3551Kathryn Naber, Volunteer Coordinator:

517-353-1669,