Thank you for your interest in volunteering for the Inside/Out Program. Please review and complete the materials. When you are finished please copy and paste your application to eric@insideoutys.org or print and mail to 235 S Nevada Ave, Colorado Springs, CO 80903.

Date: ______________________ SSN: ________________________
DOB: ______________________

Name: __________________________________________________________

Address: _________________________________________________________

Phone(s): ___________________________________
Email: ______________________________________
Best way to contact you phone/email? _____________

Occupation/Duties: __________________________________________________________

Employer & Address: _________________________________________________________

Please answer the following questions on a separate piece of paper:

1. Why are you interested in volunteering for Inside/Out Youth Services

2. What are your areas of interest in Inside/Out? (i.e. facilitating youth groups, board participation, administrative assistance, outreach or recreation supervision?)

3. List any of your skills, abilities, areas of interest that could benefit the Inside/Out program.

4. How has your life been touched by issues relating to sexual orientation?

5. Have you been or are you now, involved with a “coming out” process of any kind (yourself or others)?

6. Law requires that you report to social services that a minor was being abused by a parent. What would you do in this scenario: A youth reveals that her parents have been hitting her. She has bruises on her arms and legs. She begs you not to tell anyone.

7. Describe your response to a youth who tells you that he doesn’t use any form of protection during sex, and he wouldn’t care if he contracted or spread HIV?

8. How would you handle a situation if a youth said s/he was attracted to you?

9. How do you work within a team, and what role do you most often see yourself taking in a team-oriented situation?

10. Have you ever been convicted of any felony, child abuse, or unlawful sexual offense?
Yes ________ No__________

11. Please list any current or past volunteer experience:

Please list three (3) references you have know for at least one year, not related to you and not your partner.

Name: ______________________ Phone: ___________________ Relationship: ________________
Name: ______________________ Phone: ___________________ Relationship: ________________
Name: ______________________ Phone: ___________________ Relationship: ________________

Emergency Notification
Name: ______________________ Phone: ___________________ Relationship: ________________