What Are Some Personal Qualities and Skills You Have Which Would Make You an Effective

VOLUNTEER TELEPHONE CRISIS SUPPORT WORKER APPLICATION FORM
1. Contact Details
Surname / Given Name(s)
Preferred Name / Title / Mr / Mrs / Miss / Ms / Dr
Address
Suburb / Postcode
Phone / Business / Mobile
Email: / Gender: / Female / Male
D.O.B: / Age:
2. Emergency / Next of Kin Contact Details
Surname / Given Name
Address
Phone / Business / Mobile
Email
Relationship
3. Employment Details
Current Employment (if any) / Full Time / Part Time / Casual
Current hours and days worked
Employer
Previous Employment (if any):
4. Qualifications
Level of study completed
Course / Major
Institution / Year Completed:
Current Study / Full Time / Part Time
Tertiary Institution
Course / Major
5. General
Have you ever worked for, or been a volunteer for, Wesley Mission Victoria?YES NO (circle)
If Yes, please give details:
Have you ever previously applied to be a volunteer Telephone Crisis Support Worker with Lifeline Melbourne or been accepted into the Certificate IV Training or CSWT training? YES NO (circle)
If Yes, please give details (including dates):
Have you ever previously applied to be a volunteer or trained as a Telephone Crisis Support Worker with any Lifeline Centre ? YES NO (circle)
If Yes, please give details (including dates):
Do you know anyone who is either currently a Volunteer Telephone Counsellor with Lifeline Melbourne, or has applied to become a volunteer Telephone Counsellor?
If yes, please list their name:
What made you think of being a volunteer for Lifeline Melbourne?
 Saw advertisement in media
 Recommended by my course
 Have friend who is current/past Lifeline volunteer /  Other (please specify):
Past and present voluntary work:
6. Personal

What are some personal qualities and skills you have which would make you an effective telephone counsellor?

List three ways in which you anticipate being a volunteer counsellor may benefit you personally / professionally?

Briefly describe one of your own life experiences (preferably recent) that's taught you something about yourself?

a) What was the experience (and how long ago)?
b) What was hardest about the experience for you?
c) What did you learn from it?
d) How do you think this experience would help you as a counsellor?

How well do you work with Feedback?

Think about a difficult piece of feedback you received recently, a comment or criticism that had an emotional impact on you. It could be feedback from your partner, child, boss, colleague, friend, lecturer etc., and you may or may not have agreed with it.
Some examples to help you ….someone in your life might have said something like:
 “You’re spending too much time at work / out with your friends / on the internet”
 “You’re so scary Mum, no wonder I don’t tell you anything”
 “It seems like you’re having some difficulty understanding the work here”
 “You’re always criticising other people why don’t you look at yourself for a change”
a) What was the feedback?
b) What was it about the feedback that made it difficult for you to hear?
c) How did you respond? (e.g. did you have a physiological response, what were you saying in your head, what, if anything, did you say to the other person?
d) In hindsight, is this how you would like to have responded? Given the opportunity, what would you like to do differently?
If you have not received any such feedback recently comment on why you think that might be?
5. Do you have any injuries, diseases, or conditions (e.g. visual impairment, limited mobility) which might restrict your ability to work as a volunteer?
Yes / No
If Yes, please provide details:
Please specify any additional information about special circumstances that may have a bearing on your application (e.g. length of commitment, transport difficulties):
7. Training
The Crisis Supporter Workplace Training (CSWT):

Semester 2/2016 and Semester 1 2017  November 2016-May 2017

Please refer to the training calendars for specific dates (on the website)
An offer to train is subject to application review, group interview and a satisfactory police check.
8. Commitment
Lifeline provides a 24 hour telephone crisis counselling service with volunteers working the service at all hours. Approximately 80% of our calls are received outside of normal business hours ie. outside 9.00 am to 5.00 pm Monday-Friday. Therefore, it is important that you are available for at least some of your shifts out of hours.
After completion of training, your commitment includes:

64 hours following face to face training and student placement, over a period of 9 months to be accredited
Peak shift requirements(evening and weekends) provided at interview
Supervision and Professional Development schedule provided at interview

We ask all volunteers to provide at least a two year commitment to Lifeline
How do you see the all the above fitting into your personal / professional schedule?
9. Reference
Please provide a character or personal reference letter from a workplace, other volunteer or community organisation, a place of study or from a long term acquaintance (excluding family members or relatives) with regards to your suitability for the role. The person providing the reference letter should be from someone you have known for a minimum of 18 months. The reference needs to be current and dated. NB: A phone number/email address is not sufficient. We do not contact referees to provide character references.
Your application will not be processed until we receive your character reference letter.
The person who provides the reference should also give us phone or email details for additional follow up as required.
10. Before submitting an application please read:
The application process is as follows:

All documents required for the application are accessed at our website

Application Form to be completed with Character Reference letter and returned to

NB: No application will be processed unless it is complete including reference

You will receive an email acknowledging your application
Application reviewed by Training staff and Counselling Services staff at Lifeline Melbourne

Follow up from the Training staff may occur as required (should we require further clarification regarding your responses)

If application review is successful, you will be invited to a group interview

If successful on interview, you will be invited to train with us, pending a satisfactory police check and payment of a deposit of $250 course fees with the balance $700 due 6 weeks before course commencement

If you are not successful at any stage of the application process, we will inform you.

We encourage you to view our website for updates and to read the documents which relate to the application Once you access the website click on Lifeline
The information provided on the website gives you a great overview of the role as a Lifeline Crisis Supporter, which now ensures you could effectively work in any Lifeline phone room in Australia. This training has become invaluable in assisting our many callers from across the nation.
I certify that to the best of my knowledge, these particulars are true and correct and that I have not knowingly provided any false or inaccurate information.
I also have read the:

CSWT Pre-enrolment Course Information documents
Basic Information about shift requirements outside of BH and will receive details if successful at application stage and invited to an interview .I understand the commitment required both as a student and volunteer of Lifeline Melbourne
Application process information

Name / Signed / Date / ___/__/___

Please email your completed application to:

Lou Purcell and Karen Richards

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