One's Purpose Volunteer Form

Thank you for your interest in helping us support survivors. Due to the sensitivity of some of our work, please fill out the following form to the best of your ability and with as much information as you feel comfortable sharing. If you have any questions, please don't hesitate to reach out to us directly at admin@onespurpose.org.

Contact Information

First name

Last name

Gender:

Male

Female

Birthday

Día

Mes

Año

Any Alias/Maiden Names?

Current Address:

Permanent Address (if different):

Mailing Address (if different):

Phone Number:

Cell:

Email:

Occupation

Citizenship Status

Driver's License #/State:

If married, spouse name:

Emergency Contact Name

Emergency Contact Phone

Background Check

We require that our volunteers obtain a background check. If you have one, please attach the latest copy. Otherwise, please obtain one from the FBI's website here.

Upload your background check here.

Personal Information

Have you ever been arrested/convicted of a felony? If so, explain when/where/what happened:

Have you ever been addicted to a substance of any kind? If so, explain when/where/what happened:

Have you ever been a victim of domestic violence? If so, explain:

Are you a survivor of any form of human trafficking? If so, explain:

Please list any local or national clubs, associations, and religious organizations you belong to:

Have you ever served in any branch of the Armed Forces?

Yes

No

If you answered yes, when did you start?

When did your service term end? Leave blank if current.

Please list any specialized training you received in the military:

Have you ever been treated for a mental or emotional condition? If yes, please explain:

Do you have any special physical needs that you would like for us to be aware of?

Do you have any medical conditions that you would like for us to be aware of?

What are your current job(s)?

Do you have a valid concealed carry handgun permit?

Yes

No

If yes, please list in which states you are permitted to carry:

What weapon training programs have you completed?

References

Professional Reference (supervisor/manager/boss)

Name:

Company/Organization:

Relationship:

How long have you worked with this person?

Office Address:

Contact Phone:

Contact Email:

Does this person know that we will be contacting him/her?

Yes

No

Family Member Reference (should be an immediate family member)

Name:

Relationship:

How long have you known this person?

Address:

Contact Phone:

Contact Email:

Does this person know that we will be contacting him/her?

Yes

No

Personal Reference #1

Name:

Relationship:

How long have you known this person?

Address:

Contact Phone:

Contact Email:

Does this person know that we will be contacting him/her?

Yes

No

Personal Reference #2

Name:

Relationship:

How long have you known this person?

Address:

Contact Phone:

Contact Email:

Does this person know that we will be contacting him/her?

Yes

No

Statement of Understanding

Please download the following files and upload a complete copy of each before submitting.

Statement of Understanding

NDA

Training

One's Purpose requires that advanced volunteers become certified in Trauma Informed Care (TIC). Please complete the training from Trauma Informed Oregon available here, and upload your certificate of completion below. The training consists of four self-paced modules and should take no longer than two hours.

Trauma Informed Certificate of Completion

Thank you again for your interest in helping support our mission. We will be in touch soon!