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Application for Victim Advocate Community of Practice
*
1.
Contact Information
(Required.)
Name
Job Title
Organization
Street Address
City/Town
State/Province
ZIP/Postal Code
Email Address
Phone Number
2.
Organization Website
3.
Victim Advocacy Type: Pick one of the following that most closely reflects your work.
Adult or child protection based victim advocate
Culturally or linguistically specific program based victim advocate
Domestic violence program: victim advocate
Dual domestic violence/sexual assault program: victim advocate
Faith based program victim advocate
Health care based victim advocate
Immigrant community based victim advocate
Law enforcement agency based victim advocate/victim witness
Legal Aid Based Victim Advocate
Prosecution based victim advocate/victim witness
Sexual Assault program: victim advocate
State coalition victim advocate
Other (please specify)
*
4.
Organization type
(Required.)
Adult Protective Services
Batterer Intervention Program
Child Protection Worker
Corrections
Culturally Specific Community Programs
Disability/Deaf Organization Staff (and Boards)
Domestic Violence Program
Dual Sexual Assault and Domestic Violence Program Staff (and Boards)
Elder Abuse/Aging Program
Faith-Based Organization Staff
Family Justice Centers
Forensic Examiner Program
Gov: Law Enforcement
Gov: Prosecutor's Office
Gov: Court/Judge
Health Care Provider
International Organization
Legal Services/Family Attorneys/Law Students
Media
Mental Health Care
Other National TA Provider
Public Defender/Criminal Defense
STOP
Sexual Assault Program Staff
State, Tribal and/or Territory Coalition (Staff and Boards)
Transitional Housing Program
University/Policy Institute/Educator
Other (please specify)
5.
Type of Grant
ARREST
Culturally & Linguistically Specific
FVPSA
Legal Assistance for Victims
OVC
RURAL
State Coalition
STOP
Technical Assistance
VOCA
Other (please specify)
*
6.
For a once a month meeting by webinar or conference call, what is the best day of the week to meet?
(Required.)
7.
Please indicate your total years of experience working with survivors of domestic violence, sexual assault, stalking, dating violence and/or human trafficking?
8.
Please indicate your total years of experience working with immigrant or refugee survivors domestic violence, sexual assault, stalking, dating violence and/or human trafficking?
9.
What are the estimated number of immigrant victims/survivors you have supported with safety planning?
10.
What are the estimated number of immigrant victims/survivors you have supported in getting a protection order?
11.
What are the estimated number of immigrant victims/survivors you have supported in securing shelter, transitional housing, housing issues?
12.
What are the estimated number of immigrant victims/survivors you have supported in securing access to health care, public benefits, food assistance?
13.
What are the estimated number of immigrant victims/survivors you have supported in family law cases (e.g. custody, child support, divorce)?
14.
What are the estimated number of immigrant victims/survivors you have supported in criminal court cases?
15.
What are the estimated number of immigrant victims/survivors you have helped gain language access to services and/or help from the justice system?
16.
What are the estimated number of immigrant victims/survivors you have helped with immigration issues?
17.
Have you supported immigrant victims/survivors who have applied for a VAWA self-petition immigration application?
Yes
No
18.
If so, approximately how many? Tell us how you supported them.
19.
What is your comfort level with assisting with screening for VAWA Self-Petitions eligibility for immigrant survivors (1-5)? (1 = not comfortable; 5 = comfortable)
1
2
3
4
5
20.
Have you supported immigrant crime victim/survivors who have applied for a U visa immigration applications?
Yes
No
21.
If so, approximately how many? Tell us how you supported them.
22.
What is your comfort level with assisting with screening for U visa eligibility for immigrant survivors (1-5)? (1 = not comfortable; 5 = comfortable)
1
2
3
4
5
23.
Have you supported immigrant crime victim/survivors in obtaining U visa certifications?
Yes
No
24.
What is your comfort level with asisting with screening for SIJS eligibiliy for immigant survivors or their children (1-5)? (1 = not comfortable; 5 = comfortable)
1
2
3
4
5
25.
What is your comfort level with asisting with screening for T visa eligibiliy for immigant survivors (1-5)? (1 = not comfortable; 5 = comfortable)
1
2
3
4
5
26.
Approximately how many victims/survivors have you worked with that have limited English proficiency?
27.
Approximately how many times have you worked with interpreters or translators?
28.
Discuss any training you have received on VAWA immigration based remedies?
29.
What issues and/or areas relating to immigrant victims of crime are you most interested in learning about? Check all that apply.
Battered Spouse Waivers
Best practices for serving immigrant victims
Building collaborations with law enforcement
Child Support
Criminal Court Issues
Culturally Sensitive Services
Custody
Divorce
Economic Relief
Family Court Issues
Food Assistance
Healthcare
Housing
Immigration Relief
Language Access
Learning from judges
Protection Orders
Public Benefits
Safety Planning
Special Immigrant Juvenile Status (SIJS)
T Visa
Trauma-Informed Assistance
U Visa
VAWA Confidentiality
VAWA Self-Petition
Other (please specify)
30.
What skills are you interested in strengthening?
31.
What do you find most challenging about working with immigrant victims/survivors of domestic abuse, sexual assault, stalking dating violence and/or human trafficking?
32.
In what area of safety planning are you encountering the most challenges for immigrant survivors/victims?
33.
What area of safety planning do you feel you have the most experience in supporting survivors/victims?
34.
What areas of your work do you find most rewarding?
35.
Do you enjoy working in team-oriented settings with others?
Yes
No
36.
Are you willing and able to voice feedback in a respectful constructive manner?
Yes
No
37.
If you are an experienced victim advocate, how would you mentor or support newer victim advocates?
Yes
No
38.
If you are a new victim advocate, what kind of mentorship opportunities are you looking for?
39.
Do you speak any languages other than English? If so, which ones?
40.
Describe your experience working with underrepresented persons in your community.
41.
Have you ever provided instruction or training for others working with survivors of abuse?
Yes
No
42.
Can you tell us a little about the trainings you have done?
43.
Are you involved in any Collaborations that assist you in you work with victims/survivors?
44.
List the 5 most common countries of origin that the victims/survivors you work with come from?
45.
What are the 5 most common languages do most of survivors/ victims you work with speak?
46.
We value access and safety, and we strive to make our meetings accessible and welcoming to all participants. Are there accommodations we could provide you that would improve accessibility for you to our virtual meetings, materials, or anything else?
47.
Is there anything else you would like to share with us to consider with your application?
