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 OptionMay 18 - 19, 2023; 9 am - 4 pmThe Mediation Center receives funding to provide the Restorative Conferencing Training for free. 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