24-Hour Crisis Hotline


Volunteer Application

Volunteer Application

    The policy of Montgomery County Women’s Center does not allow former clients to volunteer or intern if they have received services from MCWC within the last six months.

    Are you a current or former client of MCWC NoYes

    Please Submit All Information

    Your Full Name (required)

    Your Email (required)

    Home Address



    Zip Code

    Home Phone

    Office Phone

    Cell Phone

    Date Of Birth


    Occupation / Job Title

    Marital Status

    Spouses Name (if applicable)

    How Did You Learn About Our Volunteer / Intern Program?
    NewspaperRadiotelevisionSpeaker from MCWCMCWC VolunteerSchoolOnline

    What Languages Do You Speak Fluently?

    What Languages Do You Read and Write?

    Special Skills or Hobbies

    Which Volunteer Opportunities Are You Interested?
    AdministrativeSpecial EventsTelephone AdvocateChild CareShelter AssistanceChild ActivitiesResale ShopLegal AccompanimentOther

    Thank you for your interest in the MCWC volunteer and/or intern program. We appreciate your desire to become an advocate for domestic violence and/or sexual assault survivors, their family members and friends.

    Are you currently on probation or parole or completing community service hours?

    If Yes, Please Explain:

    Have you been arrested, charged or convicted of an assault(s) or a felony?

    If Yes, Please Explain:

    Have you been under investigation through TDFPS (CPS and APS)?

    If Yes, Please Explain:

    Volunteer/Intern Emergency Medical Information Form

    Submission of this information and form is voluntary for all MCWC volunteers/interns. This form is intended only as a source of information in the event of a life threatening illness or injury.

    Emergency Contact Name

    Emergency Contact Phone Number

    Relationship To You

    Name of Physician

    Physician's Phone Number

    Choice Of Hospital

    Hospital Phone Number

    List any existing medical conditions (diabetes, hypertension, etc.)

    List all allergies to foods, medications, etc. and describe symptoms of reactions:

    List all medications taken regularly:

    Are You Pregnant?

    Do you wear contact lenses?

    I have read and understand the above information. I hereby authorize Montgomery County Women’s Center to conduct a background and reference check.

    I understand