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*.   Today's date:    Click Here to Pick up the date
 
*.   Name (first and last):   
 
*.   Mailing Address (line 1):   
 
  .   Mailing address (line 2):   
 
*.   City/Town:   
 
*.   Zip Code:   
 
  .   State:   
 
  .   Email address:   
 
  .   Phone number:   
 
*.   How do you prefer to be contacted?   
 
*.   Have you completed a 40-Hour Mediation training?
IF YES: Please provide the dates of your training, the organization that provided it, and the names/contact info of your trainer(s)
IF NO: will you be willing to participate in a Solve-It! 40-Hour training and receive a volunteer's discount?
 
*.   Are you willing to commit to 5-10 volunteer service hours with Solve-It! per month for one year?   
 
*.   Are you willing to be fingerprinted and/or submit to a background check prior to serving as a mediator or trainer?   
 
*.   Which Solve-It! program initiatives and/or operations are you the most interested in volunteering with (check all that apply)?
Community Mediation
Conflict Coaching
Conflict Resolution Seminars and Workshops
Mediation Training/Instruction
School-based Peer Mediation Training
Mediation Case Development (in office)
Public Relations
Other (please explain):
 
*.   How would your background and talents best serve such initiatives or operations?
 
*.   What dates and times are best for you in terms of volunteerism?   
 
*.   Please cut and paste your resume into this box:
 

The personal information that you submit in this form is sent directly to the Program Coordinator of Solve-It! Community Mediation Service and is confidential--it will not be shared with any outside party.



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Last update time: Jul 1, 2011 05:11 PM   
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