Volunteer Hotline Counselor Application

Name*

First NameLast Name

Your Email*

example@example.com

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Primary Phone Number*

ex. (888) 123-4567

Other Phone Number

ex. (888) 123-4567

Are you 18 years or older?*

YesNo

How long do you plan to live in Tallahassee?*

Are you fluent in any language other than English?

SpanishHaitian CreoleOther

Are you currently enrolled in college?*

YesNo

Please list your college, year, and major

Please list your college, year, and major*

Have you ever pled guilty or “no contest” to a crime, been convicted of a crime, had adjudication withheld, prosecution deferred or do you have criminal charges pending? (Answering yes does not constitute an automatic rejection for volunteering. Date of the offense, seriousness and nature of the violation, and rehabilitation will be considered. All agency members must also pass a background check upon admittance.)*

YesNo

Please give dates and details of each

References

List three references, preferably two professional (employer, academic professor, etc.) and one personal (not a relative/family member). If you do not have a professional reference, list personal references. To aid in timely acceptance, please inform your references that they will receive an email following your interview.

Reference 1 Name*

First NameLast Name

Type of 1st Reference*

ProfessionalPersonal

Organization & Position

Dates of Employment or Length of Relationship*

e.g. June 2019-May 2022 OR 6 years

Reference 1 Email*

example@example.com, preferred

Phone Number*

Best number at which to reach them

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Reference 2 Name*

First NameLast Name

Type of 2nd Reference*

ProfessionalPersonal

Organization & Position

Dates of Employment or Length of Relationship*

e.g. June 2019-May 2022 OR 6 years

Reference 2 Email*

example@example.com, preferred

Phone Number*

Best number at which to reach them

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Reference 3 Name*

First NameLast Name

Type of 3rd Reference*

ProfessionalPersonal

Organization & Position

Dates of Employment or Length of Relationship*

e.g. June 2019-May 2022 OR 6 years

Reference 3 Email*

example@example.com, preferred

Phone Number*

Best number at which to reach them

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Experience

Please tell us about any present or prior work or volunteer experience by uploading your resume or CV below.
Experience is helpful, but is not required to be accepted as a volunteer with our program.

Resume or CV

Employer 1

Dates Employed

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Best number at which to reach them

Position

Supervisor

Description of Duties

Reason for Leaving

Employer 2

Dates employed

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Best number at which to reach them

Position

Supervisor

Description of Duties

Reason for Leaving

Word Processing/Computer Skills

2-1-1 Big Bend counselors use computer software to retrieve information and referrals for callers and to document statistical information. Please indicate your proficiency in the following areas:

Ability to operate programs based in Windows*

I would need regular assistanceI can navigate with little to no assistanceI feel comfortable assisting others or finding solutions to issues

The ease at which you learn unfamiliar programs based in Windows*

It takes me a long time to learn new programsIt takes me some time to learn new programsIt takes me very little time to learn new programs

Your skill level in searching for information on the internet*

I would need regular assistanceI can navigate with little to no assistanceI feel comfortable assisting others or finding solutions to issues

Use of Hotlines

Use of our hotlines will not necessarily affect your suitability for our volunteer program.

I have contacted Helpline 2-1-1, the National Suicide Prevention Lifeline, or another 2-1-1 Big Bend counseling hotline for assistance within the past year.*

YesNo

Empathy Assessment

After each situation description, list several emotions that someone calling Helpline 2-1-1 might be feeling. You do not need to respond with how you would handle the problem. Respond with possible or probable feelings. We are not looking for specific counseling skills, but are interested in your natural ability to empathize. Remember that we often feel more than one feeling at a time and it is not uncommon to feel conflicting emotions.

A woman calls and is very upset because of a fight she just had with her 11-year-old son. She feels strong discipline is necessary, but knows that physical punishment sometimes gets out of hand. She wants help, but doesn’t want to go to a counselor because she believes that her son will be taken away from her.

A woman calls and is very upset because of a fight she just had with her 11-year-old son. She feels strong discipline is necessary, but knows that physical punishment sometimes gets out of hand. She wants help, but doesn’t want to go to a counselor because she believes that her son will be taken away from her.*

A man, dying of AIDS, calls you sobbing. His family has disowned him, he lost his job 7 months ago, and today his partner decided to end their relationship.

A man, dying of AIDS, calls you sobbing. His family has disowned him, he lost his job 7 months ago, and today his partner decided to end their relationship.*

A woman calls who has an infertility problem and has been looking into adopting a child. She has been waiting for something to work out, but today she was turned down once again. She thinks that it may have to do with her disability; she is confined to a wheel chair.

A woman calls who has an infertility problem and has been looking into adopting a child. She has been waiting for something to work out, but today she was turned down once again. She thinks that it may have to do with her disability; she is confined to a wheelchair.*

You receive a call from a woman in her late fifties; her only child is getting married soon. She is extremely happy for her child, but afraid that when he leaves home she will have no one to talk with. Her spouse doesn’t pay much attention to her anymore.

You receive a call from a woman in her late fifties; her only child is getting married soon. She is extremely happy for her child, but afraid that when he leaves home she will have no one to talk with. Her spouse doesn’t pay much attention to her anymore.*

Situational Assessment

Please tell us what you would do in the following situation. We are not looking for the “right” answer; we are interested in your instincts. Write your answer below.

You receive a long distance call from a friend, who just broke up with a long-term partner and is very emotional, sobbing heavily, and having difficulty speaking.*

Individual Sensitivites

Training and volunteering with 2-1-1 Big Bend, Inc. requires you to deal with a variety of issues and react to many different situations. In order to help us best prepare you for your role as a hotline counselor, please indicate below which of the following issues may be so sensitive or uncomfortable for you that you feel your ability to complete training or counsel on the hotline may be affected. Sensitivity to these situations will not necessarily bar you from training, but will alert the staff to special needs you may have and help us tailor our training to meet those needs.

Please select any issue(s) which you feel like you would be unable to counsel or discuss with someone even after training:*

Commitment Agreement

The following statements are designed to ensure that you understand all of the commitments involved in training and volunteering with 2-1-1 Big Bend, Inc.

If any answer is "no," please provide an explaination in the respective text box.

Training is usually conducted from 7:00PM to 9:30PM every Tuesday and Thursday. Some training sessions (see current schedule) may last until 10:00PM. Training may also take place on a Saturday or Sunday (see current schedule). You will be expected to attend all training sessions.*

YesNo, please explain

Attendance at all training sessions is vital to becoming a competent hotline counselor. I understand that if I should have to miss a session due to an unforeseen emergency, I will contact a member of training staff prior to that session, and agree to promptly make up a missed training session. I also understand that being late to a training session counts as half an absence. I understand that I am only allowed a maximum of two absences. I understand that I may be dismissed from the training program due to absences or lateness.*

YesNo, please explain

Around the second week of classroom training, you will begin phone room training and then later begin supervised shifts that will involve a commitment of three hours a week in addition to classroom training. These additional hours will be scheduled according to your availability. I agree to commit to these additional hours of training*

YesNo, please explain

There is a $50 fee for training materials. No one will be denied the opportunity to train because they are unable to afford these fees. We will work with you to make alternative arrangements if necessary. I agree to pay the fees OR speak with a member of training staff*

YesNo, please explain

In order for 2-1-1 Big Bend, Inc. to operate and serve the community, all volunteers must fulfill a 211-hour commitment of service after they have completed the initial training program. By going through our training program, you are agreeing to make decisions in your life over the next year based on your volunteer commitment to 2-1-1 Big Bend, Inc. I have read the volunteer counselor position description, and I agree to complete my 211-hour commitment to 2-1-1 Big Bend, Inc.*

YesNo, please explain

I agree to volunteer for at least three (3) three-hour hotline shifts each month once I have completed the initial training program.*

YesNo, please explain

I agree to volunteer for at least one overnight shift (11:00PM-8:00AM) per month once I have completed the initial training program.*

YesNo, please explain

I agree to volunteer in-person for the first 100 hours of my volunteer commitment.*

YesNo, please explain

I understand that all incoming and outgoing calls on the hotline are recorded for quality assurance and therefore my calls will be part of that record.*

YesNo, please explain

2-1-1 Big Bend, Inc. is a drug free workplace. I will not use alcohol or illegal drugs before or during training class or hotline shifts. If I am under 21 years of age, I will not drink alcohol at any 2-1-1 Big Bend, Inc. social functions.*

YesNo, please explain

To ensure trainees are progressing through the program in a timely manner, all trainees must agree to availability following their respective training semester. During these periods, you are agreeing to availability for at least one phone shift per week and one overnight per month. Please indicate, respective to your training semester, if/when you will be available.

I am applying for the:*

Spring (training starts in January)Summer (training starts in May/June)Fall (training starts in Aug/Sept)

Spring – I agree to be available during either the first half (May-June) or second half (July-August) of summer

May - JuneJuly - AugustBothNo, please explain

Summer – I agree to be available through the second week of December and return the second week of January

YesNo, please explain

Fall – I agree to be available through the first week of May

YesNo, please explain

Applicants should possess the ability to retrieve resources from a computer and web applications such as a web chatting service. Applicants should possess the ability to use a telephone to communicate with clients as well as being able to use a phone and chat service simultaneously in order to communicate with an Off-Site Supervisor. Applicants must be fluent in English (including speaking, writing, and comprehending). This includes the ability to establish a relationship with our callers, identify their problems, reflect their feelings, and explore alternatives. Since our services are provided via telephone this may require the ability to identify subtle inferences about a caller’s situation, thus a solid command of the English language is required.

I am able to perform the duties as described above.*

YesNo, please explain

I need assistance to perform the duties as described above.*

NoYes, please explain

By signing this application, I certify that all of the information that I provide on this application and in any interview will be true, complete and accurate. I understand that if I am selected as a volunteer and any such information is later found to be false or misleading in any respect, I will be dismissed. I further understand that 2-1-1 Big Bend may contact my previous employers and I authorize those employers to disclose to 2-1-1 Big Bend all records and other information pertinent to my employment with them. I release my previous employers from any liability as a result of their disclosure of information about me to 2-1-1 Big Bend. I also authorize 2-1-1 Big Bend to provide truthful information concerning my volunteer work to my future prospective employers and I agree to hold it harmless for providing such information.

Initial and Date*

It is the policy of 2-1-1 Big Bend to provide equal employment opportunities and non-discrimination practices. 2-1-1 Big Bend will advertise for, recruit, and employ qualified personnel and recruit qualified volunteers, without regard to age, race, creed, religion, color, gender, gender identity or expression, sexual orientation, national origin, disability, veteran status, marital status, or genetic information. No employee or volunteer will be subjected to discrimination in employment conditions or volunteer working practices of the Agency. The President is charged with the responsibility of ensuring the Agency's compliance with this policy.

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Volunteer Hotline Counselor Application

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