Application to be a Restorative Conferencing Volunteer Facilitator Thank you for your interest in supporting the community by volunteering. Please complete this form, and allow our team members a few days to process your application. We look forward to speaking with you.Name* First Last Address* Street Address Address Line 2 City 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 State ZIP Code Phone*Email* Confirm Email* Please Choose a Training to Attend*Please Choose an OptionFeb 29 - March 1, 2024 (2 full days, exact time TBD)The Mediation Center receives funding to provide the Restorative Conferencing Training for free if you're providing restorative services in Chatham County, Georgia. As part of reporting requirements, please complete the following section.Gender*Please Choose an OptionFemaleMaleTransgenderPrefer not to discloseAge*Please Choose an Option14 or under15 - 19 years20 - 34 years35 - 64 years65 - 84 years85+Household Income*Please Choose an Option$0 - $9,999$10,000 - $24,999$25,000 - $49,999$50,000 - $74,999$75,000 +UnknownRace*Please Choose an OptionAfrican descentAsian/South Pacific descentCaucasian/European descentHispanic/Latino descentIndigenous descentMulti-racialRace Not Identified AboveUnknownEmployer* If unemployed, please identify as "Unemployed," and if self-employed, please identify as "Self-employed" in the field box.Have you been a victim of a crime?*Help our team know more about your interest in Restorative Conferencing.COMMUNITY SERVICE: In the field below please share your involvement with any groups or organizations.*AVAILABILITY: Which days and hours would you be available to facilitate?*How did you hear about volunteering at the Mediation Center?*Do you speak any other languages?*What is your interest in taking this training? What do you hope to learn?Resume of ApplicantMax. file size: 2 GB.A resume is helpful to process your application. If one is available, please upload your resume or email it to spraylo@mediationsavannah.com.Volunteer ProvisionsConsent to Volunteer Provisions* By applying to volunteer at The Mediation Center, applicants agree to these provisions:Volunteer Availability: I commit to volunteering for an average of ten Community Conferences per year. (preparation and conference time is approximately 5-10 hours per conference). Number of hours is dependent upon how many people are involved in the situation. Confidentiality: If accepted as a volunteer for The Mediation Center, I understand I may be privy to confidential information and agree to respect and maintain all confidential information whenever presented with it. Intellectual Property: I understand that in the course of volunteering I may participate in or create intellectual property on behalf of The Mediation Center. I understand that all such property, and all rights to its use, belong exclusively to The Mediation Center. Permission to use image: I understand that at many Mediation Center events, staff or volunteer photographers take pictures and videos. I understand the Mediation Center may use these images for community outreach, social media, reports, and fundraising. I give the Mediation Center permission to use my image taken at Mediation Center events for the purposes of community outreach, social media, reports, and fundraising. Permission to contact: I give permission for my contact details to be used by the Mediation Center to inform me of its activities relating to my work as a volunteer. I understand the Mediation Center will not pass contact details to any other organization. Terms of Volunteering: I understand that in order to ensure quality service, the Mediation Center maintains all authority over who volunteers and that at any time I may be dismissed as a volunteer.Understanding Certificate Completion* I understand the following must occur to receive a Restorative Conferencing Certificate:Practicum: I must observe a Restorative Conferencing facilitator facilitate sessions prior to facilitating a session on my own. I will co-facilitate sessions and perform debriefs with a Restorative Conferencing facilitator prior to facilitating on my own. I will invite a Restorative Conferencing facilitator to observe my sessions and debrief to support continuous learning of myself and other facilitators.Application Confirmation* I confirm the information I have provided in my application is accurate.Thank you. A copy of your responses will be emailed to the address you provided Δ