Why IVC? Spiritual Support Program Information Session with Sr. Jean Dolores Schmidt, BVM Return to IVC Regional Offices IVC Online Service Corps Member Application Step 1 of 11 9% RegionPlease select the IVC region to which you want your application sent. Albany (NY) Baltimore Chicago Denver Milwaukee Minneapolis - St. Paul National Capital Area New England New Orleans New York NE Pennsylvania Omaha Philadelphia/NJ San Diego St. Louis Syracuse Virtual Name First Last Email Phone Number (Primary)Phone Number (Secondary) AddressEnter unit/apartment in Street Address line. Street Address City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Date of birth MM slash DD slash YYYY SexFemaleMaleHouse of Worship Religion City State How did you first learn of IVC? What is your work status?RetiredSemi-Retired/Working Part TimeWorking Full TimeOtherIf retired, approximate date of retirement: In the following sections, please describe your Education, Work Experience, and any Past Volunteer Work. You may include this information in a separate resume. Please note, that extensive education or experience is not required for membership in IVC. Education: Please describe your education, including names of schools, areas of concentration, degrees, vocational training, or licenses you may have acquired.Did you attend a Jesuit High School and/or University? If yes, which one(s)? Please include city and state.Work Experience: Please list your most recent place/s of employment, what type of work you did, special training you received, and the years you worked there. (Please attach resume to application if you have one.)Upload Resume Drop files here or Select files Accepted file types: pdf, doc, jpg, Max. file size: 50 MB. Volunteer Experience: Please list any organizations in which you are currently volunteering or in which you have volunteered in the past. Also include the type of work you did the length of service.Do we have your permission to share your completed IVC application and resume, if provided, with potential IVC service sites? Yes No What else would you like us to know? Volunteer Questionnaire: Why do you want to become a part of the IVC community?How do you anticipate that the IVC community will help you grow?What types of service are you interested in doing with an IVC service site?What strengths do you bring to IVC?What skills do you have that you might like to use as an IVC service corps member? Feel free to include hobbies, domestic talents, languages, artistic, musical, or athletic abilities.What experience have you had with people of cultures other than your own?Are there any medical/psychological conditions that might affect your service? (Your response will be kept confidential and will not exclude you from consideration for IVC.)Are there any limitations or preferences regarding travel to and from service sites or IVC events? (i.e., prefer certain geographical locations; can’t drive at night; etc.) Safe Environment Training Questions: 1. Have you participated in a ‘Safe Environment’ training program (e.g. STAND, VIRTUS, etc…)? Yes No 2. If yes, who holds your records concerning this training? 3. Have you ever had a criminal history background check? Yes No 4. If Yes, in what year? 5. Many IVC partner organizations will ask volunteers to comply with their own volunteer application process as well. You may be asked to participate in a training program or give permission to the agency to perform a background check. You could be asked questions such as the following: Have you ever been convicted of a criminal offense? Have you ever been charged with neglect, abuse or assault? Do you use illegal drugs? Has your driver’s license ever been suspended or revoked in any state? Please check this box to indicate that you have been informed of this possibility. I have been informed Membership Commitment: Membership in the IVC requires a commitment to both volunteer service among the materially poor and an openness to deepening your own spiritual life. Membership runs from September through June of the following year. In light of this requirement, are you willing to commit to the following? 1. Make a one-year commitment to serve one or two days a week (or equivalent hours) at an IVC-affiliated service site? Yes No 2. Make every effort to join monthly with other IVC members for prayer, conversation, and reflection on your work? Yes No 3. Be open to deepening your own spiritual growth through individual meetings with an IVC spiritual reflector? Yes No 4. Make every effort to attend any overnight retreats or day of reflection? Yes No 5. Be willing to abide by the policies and procedures of the service site at which you choose to work? Yes No Feel free to comment on your ability to fulfill any of the above requirements. References. Please list one reference whom we may contact. They should be able to assess your general character and suitability for IVC. Reference - Professional:Please list first and last name. PhoneReference - Personal/Spiritual:Please list first and last name. PhoneDo we have permission to call one or both references? Yes No Primary Emergency ContactIn case of emergency, who should IVC contact? Secondary Emergency ContactWho else should we contact? Primary Contact's Phone NumberSecondary Emergency Contact's Phone NumberRelationship Relationship Photo Consent and SignatureFrom time to time, IVC may take photos for marketing purposes. Please check that you agree with the following statement: I hereby grant my consent to the Ignatian Volunteer Corps copyright and publication rights of my photograph and image. I understand that this photo may be used in multiple media including; print, video, and website media. I further grant the Ignatian Volunteer Corps, its assignees, contractors, licensees, sponsors, and transferees the right to print my name with the photograph/image.Signature Date MM slash DD slash YYYY Δ
