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Required fields are marked with an asterisk (*). One of the fields below is a file upload/attachment, the file size must be less than 10MB.First Name *
Last Name *
Name as shown on ID *
Mobile Phone
For example, 123-456-7890
SMS (text) messaging:
You may opt-in to receive SMS (text) for WAVE volunteer activities, including shift reminders and cancellations.
To opt-out, reply STOP to any SMS message OR update the SMS opt-in setting in your profile.
Date of Birth
A valid date as MM/DD/YYYY (for example: 11/30/2015)
Mailing Address
Preferred Method of Contact
List fluent languages
Please mark the skills and expertise you will bring to us that will strengthen WAVE and enhance the ability of our organization to deliver on its mission. Select all those that apply:
List highest level of education, prior experience, or certifications:
What accommodations, if any, do you need to fully participate in activities successfully?
Other accommodations:
Have you ever been convicted of a violation of federal or state law, excluding minor traffic violations, within the last 15 years? *
You answered yes to 'Have you ever been convicted of a violation of federal or state law, excluding minor traffic violations, within the last 15 years?' Please explain:
Have you been subject to an investigation or disciplinary action pertaining to Domestic Violence, Stalking, Sexual Assault, Child Abuse or a Vulnerable Adult? *
You answered yes to 'Have you been subject to an investigation or disciplinary action pertaining to Domestic Violence, Stalking, Sexual Assault, Child Abuse or a Vulnerable Adult?' Please explain:
Which volunteer activities are you interested in (check all that apply)?
What is your volunteer availability?
Additional Application Comments:
Confidentiality Agreement
WAVE Confidentiality Verification
WAVE’S PHILOSOPHY ON CONFIDENTIALITY: Strict confidentiality standards are part of the dignity and integrity of WAVE and the safety of clients, staff, and volunteers. An important part of the relationship between an advocate and client is trust. Trust is enhanced with a policy of confidentiality. When we work with an individual victim/survivor we respect the power and dignity of that person by keeping the information shared between us confidential. Their story belongs to them, and they have the right to decide how, when and to whom it gets shared. Except in very specific circumstances defined below, it is the client’s right to be assured of complete confidentiality.
POLICY: It is the policy of the Working Against Violence for Everyone to regard information concerning clients as absolutely confidential and private. Such information is never to be used inside or outside of WAVE in any way that is casual, unauthorized, or in any way a violation of any client's right to privacy. Such indiscretions, should they occur, will be investigated immediately. The Executive Director, and other appropriate WAVE administrative staff, shall be responsible for all corrective actions taken in this regard in accordance with policies stipulated in the WAVE personnel policy. Clients will be informed of their right to privacy as well as to their obligation to protect the confidentiality of other clients.
Under certain circumstances, specific information regarding clients must be shared with persons who are not part of the WAVE program. Volunteers are bound by the confidentiality as defined by Alaska statue.
Written information regarding clients will always be minimal and kept in a locked file and destroyed after 1 year.
The circumstances under which information may be released are:
1. In cases where there is suspected or known child abuse, or abuse of vulnerable adults, as mandated by Alaska State Law requires that paid staff report such cases to the Office of Children’s Services or the Division of Senior and Disabilities Services.
2. When the client has signed a Release of Information Form authorizing information to be released to a specific agency for a specific purpose. This form will be valid for 90 days unless specified otherwise.
3. A court order is issued compelling WAVE staff or volunteers to testify. (No production of information will be made in response to a subpoena. If a court order is received, the Executive Director will be notified and the Legal Advocacy Project of ANDVSA will be contacted for assistance.)
WAVE staff, volunteers and board members will adhere to AS 18.66.200-18.66.250.
• Discussing details of a case outside the confines of the organization, even though no identifying information is revealed, could be considered a breach of confidentiality and a violation of WAVE policy.
• The fact that a case has been made public through any of the news media does not alter the fact the client still has confidentiality privileges with WAVE.
• Any information released to another agency or individual concerning any client will be thoroughly documented in the client file.
• When disclosure of client information is required, WAVE will adhere to the following:
◦ Communication between agencies concerning a client can be beneficial to a client seeking the services of other agencies in addition to WAVE. Under these circumstances the at the participants request they can sign a release permitting an exchange of information between agencies, utilizing the following procedure:
▪ We will inform participants that WAVE may not be able to control what happens to my information once it has been released and that the agency or person getting my information may be required by law or practice to share it with others.
▪ The particular agency or person to whom this information will be released must be clearly stated.
▪ It must be understood by both the client and the staff member/volunteer that the intent of such an exchange is the best interest of the client and that even with a signed release, information used not in the best interest of the client would be considered a breach of confidentiality.
▪ Release of information must be written and time limited.
WAVE Confidentiality Verification
WAVE’S PHILOSOPHY ON CONFIDENTIALITY: Strict confidentiality standards are part of the dignity and integrity of WAVE and the safety of clients, staff, and volunteers. An important part of the relationship between an advocate and client is trust. Trust is enhanced with a policy of confidentiality. When we work with an individual victim/survivor we respect the power and dignity of that person by keeping the information shared between us confidential. Their story belongs to them, and they have the right to decide how, when and to whom it gets shared. Except in very specific circumstances defined below, it is the client’s right to be assured of complete confidentiality.
POLICY: It is the policy of the Working Against Violence for Everyone to regard information concerning clients as absolutely confidential and private. Such information is never to be used inside or outside of WAVE in any way that is casual, unauthorized, or in any way a violation of any client's right to privacy. Such indiscretions, should they occur, will be investigated immediately. The Executive Director, and other appropriate WAVE administrative staff, shall be responsible for all corrective actions taken in this regard in accordance with policies stipulated in the WAVE personnel policy. Clients will be informed of their right to privacy as well as to their obligation to protect the confidentiality of other clients.
Under certain circumstances, specific information regarding clients must be shared with persons who are not part of the WAVE program. Volunteers are bound by the confidentiality as defined by Alaska statue.
Written information regarding clients will always be minimal and kept in a locked file and destroyed after 1 year.
The circumstances under which information may be released are:
1. In cases where there is suspected or known child abuse, or abuse of vulnerable adults, as mandated by Alaska State Law requires that paid staff report such cases to the Office of Children’s Services or the Division of Senior and Disabilities Services.
2. When the client has signed a Release of Information Form authorizing information to be released to a specific agency for a specific purpose. This form will be valid for 90 days unless specified otherwise.
3. A court order is issued compelling WAVE staff or volunteers to testify. (No production of information will be made in response to a subpoena. If a court order is received, the Executive Director will be notified and the Legal Advocacy Project of ANDVSA will be contacted for assistance.)
WAVE staff, volunteers and board members will adhere to AS 18.66.200-18.66.250.
• Discussing details of a case outside the confines of the organization, even though no identifying information is revealed, could be considered a breach of confidentiality and a violation of WAVE policy.
• The fact that a case has been made public through any of the news media does not alter the fact the client still has confidentiality privileges with WAVE.
• Any information released to another agency or individual concerning any client will be thoroughly documented in the client file.
• When disclosure of client information is required, WAVE will adhere to the following:
◦ Communication between agencies concerning a client can be beneficial to a client seeking the services of other agencies in addition to WAVE. Under these circumstances the at the participants request they can sign a release permitting an exchange of information between agencies, utilizing the following procedure:
▪ We will inform participants that WAVE may not be able to control what happens to my information once it has been released and that the agency or person getting my information may be required by law or practice to share it with others.
▪ The particular agency or person to whom this information will be released must be clearly stated.
▪ It must be understood by both the client and the staff member/volunteer that the intent of such an exchange is the best interest of the client and that even with a signed release, information used not in the best interest of the client would be considered a breach of confidentiality.
▪ Release of information must be written and time limited.
I have read and understand the above policy and hereby agree to the following procedures:
