Application for Victim Advocate Community of Practice Question Title * 1. Contact Information Name Job Title Organization Street Address City/Town State/Province ZIP/Postal Code Email Address Phone Number Question Title * 2. Organization Website Question Title * 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) Question Title * 4. Organization type 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) Question Title * 5. Type of Grant ARREST Culturally & Linguistically Specific FVPSA Legal Assistance for Victims OVC RURAL State Coalition STOP Technical Assistance VOCA Other (please specify) Question Title * 6. For a once a month meeting by webinar or conference call, what is the best day of the week to meet? Question Title * 7. Please indicate your total years of experience working with survivors of domestic violence, sexual assault, stalking, dating violence and/or human trafficking? Question Title * 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? Question Title * 9. What are the estimated number of immigrant victims/survivors you have supported with safety planning? Question Title * 10. What are the estimated number of immigrant victims/survivors you have supported in getting a protection order? Question Title * 11. What are the estimated number of immigrant victims/survivors you have supported in securing shelter, transitional housing, housing issues? Question Title * 12. What are the estimated number of immigrant victims/survivors you have supported in securing access to health care, public benefits, food assistance? Question Title * 13. What are the estimated number of immigrant victims/survivors you have supported in family law cases (e.g. custody, child support, divorce)? Question Title * 14. What are the estimated number of immigrant victims/survivors you have supported in criminal court cases? Question Title * 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? Question Title * 16. What are the estimated number of immigrant victims/survivors you have helped with immigration issues? Question Title * 17. Have you supported immigrant victims/survivors who have applied for a VAWA self-petition immigration application? Yes No Question Title * 18. If so, approximately how many? Tell us how you supported them. Question Title * 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 Question Title * 20. Have you supported immigrant crime victim/survivors who have applied for a U visa immigration applications? Yes No Question Title * 21. If so, approximately how many? Tell us how you supported them. Question Title * 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 Question Title * 23. Have you supported immigrant crime victim/survivors in obtaining U visa certifications? Yes No Question Title * 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 Question Title * 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 Question Title * 26. Approximately how many victims/survivors have you worked with that have limited English proficiency? Question Title * 27. Approximately how many times have you worked with interpreters or translators? Question Title * 28. Discuss any training you have received on VAWA immigration based remedies? Question Title * 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) Question Title * 30. What skills are you interested in strengthening? Question Title * 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? Question Title * 32. In what area of safety planning are you encountering the most challenges for immigrant survivors/victims? Question Title * 33. What area of safety planning do you feel you have the most experience in supporting survivors/victims? Question Title * 34. What areas of your work do you find most rewarding? Question Title * 35. Do you enjoy working in team-oriented settings with others? Yes No Question Title * 36. Are you willing and able to voice feedback in a respectful constructive manner? Yes No Question Title * 37. If you are an experienced victim advocate, how would you mentor or support newer victim advocates? Yes No Question Title * 38. If you are a new victim advocate, what kind of mentorship opportunities are you looking for? Question Title * 39. Do you speak any languages other than English? If so, which ones? Question Title * 40. Describe your experience working with underrepresented persons in your community. Question Title * 41. Have you ever provided instruction or training for others working with survivors of abuse? Yes No Question Title * 42. Can you tell us a little about the trainings you have done? Question Title * 43. Are you involved in any Collaborations that assist you in you work with victims/survivors? Question Title * 44. List the 5 most common countries of origin that the victims/survivors you work with come from? Question Title * 45. What are the 5 most common languages do most of survivors/ victims you work with speak? Question Title * 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? Question Title * 47. Is there anything else you would like to share with us to consider with your application? Done