Volunteering

Volunteers are the heart of Adam’s Place and work directly with grieving children and teens. Volunteers are paired with children in their peer support group. Volunteers go through a 25 hour training before they can become facilitators. Volunteers meet twice-monthly and meet one hour before the children and teens come to group, and meet for an hour after group. Volunteers experience the grieving process personally as they explore their own feelings about death and loss and ensure grieving children and teens an experience of a safe haven for trust and sharing.

We are always looking for volunteers for the following positions:

Fund Raising
Marketing
Help getting In-Kind donations
Facilitating groups
Spanish speaking facilitators

If you are interested in becoming a volunteer with Adam’s Place, please fill out the application below and submit it to us.

Personal Information:

Your Name (First Name, Middle Initial, Last Name) (required):
Sex:  Male Female

Physical Address (Street, City, State and ZIP Code):

Mailing Address (Street, City, State and ZIP Code):

Home Phone:

Cell Phone/Pager:
Work Phone:

E-mail Address:

Social Security #:
NV Driver's License #:
Birth Date:

Employment History

Current Employer Information

Current Occupation/Title:
Current Employer's Name:
Current Employer's Address:

Current Employer's Phone Number:
Current Employer's Dates of Employment:

First Former Employer's Information

First Former Occupation/Title:
First Former Employer's Name:
First Former Employer's Address:

First Former Employer's Phone Number:
First Former Employer's Dates of Employment:

Second Former Employer's Information

Second Former Occupation/Title:
Second Former Employer's Name:
Second Former Employer's Address:

Second Former Employer's Phone Number:
Second Former Employer's Dates of Employment:

Educational Background

Selection of Volunteers is not based on education/licenses

Are you presently attending school:  Yes No
If "Yes" please complete, the following:
Name of Current School:
Current Field of Study:
Anticipated Graduation Date:
Will you receive academic credit for your volunteer work?  Yes No

Please check those that you've completed; provide year graduated and field of study for each.
 High School:
 Specialized Training:
 Associate's Degree:
 Bachelor's Degree:
 Master's Degree:
 Doctorate:

Professional Licenses and/or Certifications:
(List Type, State, Date, Number and Expiration Date)

Emergency Information

Person to notify in case of emergency
Name:
Relationship:
Address:

Home Phone:
Cell Phone:
Work Phone:

Additional Information

Describe your experience working with children/teens (volunteer, professional, personal):

Please list specific skills, interests and personal background you believe will be helpful in this volunteer position:

Hobbies:

Languages you speak in addition to English:

If you have ever participated in a support group, please describe:

If you have ever facilitated a support group, please describe:

If you have ever been convicted* of a misdemeanor or a felony please indicate date(s) and describe the charges:

*Conviction of a crime, or pleading guilty to a criminal charge, will not necessarily disqualify you from a volunteer position with Adam's Place. Conviction will be considered with respect to time, relatedness to your work as a volunteer and other relevant factors

If you are currently under the care of a physician or psychiatrist, please describe:

Personal References

Please provide the name, complete address and phone number of a person in each of these categories who knows you well, has a definite knowledge of your abilities, personality and qualifications and whom we may contact for a reference:

Employer/Supervisor (Current or Past)

Full Name:
Mailing Address:

Phone:

Co-Worker (Current or Past)

Full Name:
Mailing Address:

Phone:

Friend

Full Name:
Mailing Address:

Phone:

Co-Worker (Current or Past)

Full Name:
Mailing Address:

Phone:

Bereavement History

Please describe any significant losses that you have experienced, please include your relationship to the deceased, the year of death, your age at the time of loss and the cause of death:

Being a Volunteer Facilitator:

Why are you interested in working with children:

What do you hope to gain personally as a result of attending this training?

What are your expectations of participation in the Adam's Place program?

Is there anything to prevent you from keeping your ten-month commitment? If yes, please explain:

Availability and Areas of Interest:

The groups meet from 5:30-8:00PM on Monday-Thursday every other week. Times include one-hour pre-meeting and one-hour post-meeting sessions for facilitators, and a one & one-half hour session facilitating children, teens or adults. There are no meetings in July and August.

Please check your availability and preference:
 Monday Tuesday Wednesday  Thursday

With which participants would you feel most comfortable spending time? Please indicate 1st, 2nd and 3rd choices of groups you'd like to work with:

First Choice:
Second Choice:
Third Choice:

I would feel comfortable working with participants who have experienced:
(Please indicate 1st, 2nd, 3rd and 4th choices)

First Choice:
Second Choice:
Third Choice:
Fourth Choice:

Please carefully read the following

Please select "Agree" to each item if agreeable and submit this volunteer form below. If not agreeable, please select "Disagree/Comment Below" and write your comments in the "Questions/Comments" box above the submit bottom at the bottom of this application.

I understand that I am required to attend 12 hours (2 sessions) of Volunteer Facilitator Training before I become a facilitator in a peer group sponsored by Adam's Place:

I understand that Adam's Place reserves the right to accept or reject any potential trainee as a facilitator even after he/she has completed 12 hours of training:

I understand that this training is offered to those who intend to volunteer for at least 10 months as a facilitator of a peer support group sponsored by Adam's Place and that the minimum commitment is for 3.5 hours per session in a group that meets every other week:

I understand that if I am accepted as a facilitator, I will be asked to complete a "Request for Nevada Criminal History Information" form and pay the fee required by the State of Nevada:

I declare the information provided by me in this application is true, correct and complete to the best of my knowledge. I authorize you to verify any and all information provided herein.

Questions/Comments:

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Adam's Place for Grief is a 501(c)(3) non-profit organization. All donations are tax deductible.

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Contact Us
Mail: 5017 Alta Drive
  Las Vegas, Nevada 89107
Phone: (702) 481-1996
Email: info@adamsplaceforgrief.org