Sexual Assault Crisis Center of Easten Connecticut
•Home•
•En Español•
•Services•
•Immediate Help•
•Prevention•
•Volunteer•
Certified Sexual Assault Crisis Counselor Training Application
Name
Street Address
Town
Zip Code
Telephone
Email Address
Occupation
Education
--- Select Highest Level of Education ---
Not yet completed high school
High school graduate
Some college
Associate's degree
Bachelor's degree
Some post graduate
Master's degree
PhD
Languages Spoken
How did you learn of the training?
Please describe any previous volunteer experience
Please list counseling experience or specialized training
When are you available to volunteer? (e.g. weeknights, weekends)
Do you have access to reliable transportation?
Reference #1 Name
Reference #1 Address
Reference #1 Telephone
Reference #2 Name
Reference #2 Address
Reference #2 Telephone