PAVSA Board Member Application

PAVSA Board Member Application

First Name: Last Name: MI:

Address:

City:

State: State... -- UNITED STATES -- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Zip Code:

Phone number:

Email:

Occupation:

Education:

How long have you lived in this area?

Have you ever work with victims of crime before? Yes No

If yes, please explain:

Have you ever been involved with a sexual assult program before? Yes No

If yes, in what capacity?

Why would you like to be a board member with PAVSA?

What is your definition of sexual assault?

Do you feel compatible with PAVSA's philosophy of choice as it relates to reproductive freedom? Yes No

What do you feel are the prevailing attitudes of people regarding victims?

What are your personal attitudes towards victims of sexual assault?

Will you be able to give a three year commitment to this program? Yes No

Do you feel comfortable dealing with issues involving sexuality? Yes No

Please list any present/previous volunteer experiences and explain your involvement: