Women's Coalition of St. Croix 

Application for Volunteer Victim Advocates

Name:

Date of Birth:

Address (home):

Address (mailing):

Employer:

Employer's Address:

Home Phone:     Work Phone: 

Cell Phone: 

email address: 

Please give a brief reason why you want to be an advocate for victims of sexual assault, battering or other violent crimes.


Please list any experiences or special qualities you feel would help you in the role.

Are you interested in becoming a support group leader?
Yes No

Submit Via eMail:


Submit Via Mail:   
Women's Coalition of St. Croix
PO Box 222734
Christiansted, VI 00822-2734
email: wcsc@pennswoods.net

Submit via Fax:(340)773-9062

Drop off at the Women's Coalition Office, 7 East Street, Christiansted

Call:  (340)773-9272 for more information