Counselor Application  ADR Application  Volunteer Application

Application for Dispute Resolution

Name:
Address1:
Address2:
Town:
State:
Zip code:
Phone:Home
Phone:Business
Email:
Relationship status:
Age and sex of your children:
Employer name and address:
Position:
Type of previous work experience:
College:
Degree:
Major:
Year:
Graduate School:
Degree:
Major:
Year:
To what groups or organizations do you belong?:
Other than English, do you speak another language fluently?
Which language?:
How did you learn about VCS?:
What is your availability?
Days:
Times:
Are you available 6 hours a month for a minimum of 12 months?
	Yes    No
Do you have any experience with mediation, arbitration or other forms of problem solving?
If yes please specify:
Have you had any counseling experience?
If yes please specify:
Why do you want to be an alternative dispute resolution volunteer?