Advocate Application Step 1 of 7 14% APPLICANTApplicant Name First Middle Last Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Home PhoneCell PhoneWork PhoneDate of Birth MM slash DD slash YYYY Place of Birth (City) Place of Birth (Prov) GenderMaleFemaleMarital Status All Names Used Since Birth (except name given above) SPOUSESpouse Name First Middle Last Spouse Date of Birth MM slash DD slash YYYY Spouse All Names Used Since Birth (except name given above) Spouse/Partner's place of employment Title Does your partner/spouse support your interest in victim services?YesNo CHILDRENChild 1 Name First Middle Last Date of Birth MM slash DD slash YYYY Child 2 Name First Middle Last Date of Birth MM slash DD slash YYYY Child 3 Name First Middle Last Date of Birth MM slash DD slash YYYY Child 4 Name First Middle Last Date of Birth MM slash DD slash YYYY EMPLOYMENTDo you have access to a vehicle?YesNoHow long have you been a resident of this area? Are you currently:EmployedUnemployedStudentRetiredEmployer How long? Position Title Supervisor May we contact your employer?YesNo EDUCATION AND TRAININGHigh School Grade Completed College/University Degree(s) LanguagesEnglishFrenchOthersOther Languages Previous Volunteer ExperienceSpecial Skills? (Computers, First Aid/CPR, Typing etc.)List clubs and organizations you belong to Victim Services UnitVictims Services Unit applying forClaresholmFort MacleodPiikani NationPincher CreekCrowsnest PassDays and Times available Why do you wish to volunteer with Victim Services?Explain any skills, knowledge or experience you have that would benefit this programExplain your expectations of volunteering for this programWill you complete the necessary training?YesNoWill you attend necessary advocate meetings, conferences & workshops?YesNo References Please list one personal and one business, education, or volunteer related references and attach a letter of reference from each.Personal Reference Name Personal Reference PhoneRelationship to you Business Reference Name Business Reference PhoneRelationship to you Consent I give permission to the Royal Canadian Mounted Police to obtain all information necessary, including a criminal records check, to qualify me as a volunteer of the victim services unit. It is understood the RCMP are not obligated to accept me as a volunteer and they will have the final authority in the approval or rejection of this application on which grounds will not be questioned. I also understand that I must undergo a security clearance by the RCMP. Any false information given in this application will be cause for rejection or immediate dismissal.I give permission to the Royal Canadian Mounted Police to obtain all information necessary, including a criminal records check, to qualify me as a volunteer of the victim services unit. It is understood the RCMP are not obligated to accept me as a volunteer and they will have the final authority in the approval or rejection of this application on which grounds will not be questioned. I also understand that I must undergo a security clearance by the RCMP. Any false information given in this application will be cause for rejection or immediate dismissal.
