East Bay Community Mediation
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Volunteer Profile

EBCM Volunteer Profile Update

If you are currently an active EBCM volunteer, use this form to send EBCM your updated profile and contact information.

This information will only be used for EBCM's internal purposes. Your information will not be shared with anyone outside EBCM without your prior permission. Volunteer profile information is not posted on EBCM's web site.
Contact Information
Last name:
First name:

Address:
City:
State: Zip:
Phone (please list in order of preference to call)

Preferred Contact Phone:

 Type:
Alternate Phone: Type:
Alternate Phone: Type:
Email address:   

Has this contact information changed in the past year?
Yes, my contact information has changed.
No, my contact information has not changed.
Please include additional information that will assist us in keeping in communication with you.
Volunteer Availability
What days and times are you usually available to volunteer? (Please check all that apply.)
  Mornings (9-12) Afternoons (1-5) Evenings (6-10)
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
In a pinch, may we:
call you at the last minute? Yes    No
call you for days you're generally not available? Yes    No

EBCM benefits enormously from the generous donation of time and energy from volunteers. In order to maintain our services, grow to meet new needs, and truly flourish, we need your help.

We ask that you devote some time each year to volunteering for EBCM in areas other than mediation, such as outreach activities, fundraising, administrative or committee work, or helping to provide trainings and workshops.

Would you be willing to volunteer a minimum of 6 hours per year to these activities, or others you'd like to propose?
Yes
No

Please indicate which areas are of interest to you (check all that apply):
training
facilitation
outreach/public relations
fundraising
case development
volunteer development
administrative support
computer/technology
youth activities
other:

Demographic Information

These questions are optional; we ask them to assist us in creating diverse panels that reflect our parties' needs and backgrounds.

Date of birth (mm/dd/yyyy):
Gender:
Sexual orientation:

How do you self-identify culturally/ethnically/racially?

Please list any languages, besides English, in which you feel comfortable mediating.


What is your occupation?

What organizations or groups are you affiliated with (professional, community, social, religious)?

What year did you begin volunteering with BDRS/CFO/EBCM?

Mediator Information
Please complete this section if you volunteer as a mediator with EBCM; otherwise, please skip this section.
Where did you receive your training as a mediator?
How many years have you been a mediator?
Based on your own perception and comfort level, please indicate your degree of experience as a mediator.
novice
intermediate
advanced

Please indicate specific types of cases you do NOT want to mediate:
neighbor
family
business/real estate
landlord/tenant
workplace
schools/youth
temporary restraining order (TRO)
police-citizen
restorative justice (victim/offender)
zoning/land use
trees

Please indicate up to three types of cases you have a special interest and/or expertise in:

Depending on your availability and preferences, how often would you like to mediate?
12 times per year (once per month)
6-8 times per year (every other month)
3-4 times a year (every 3 months)
1-2 times a year

Please add any questions, comments, or concerns here:

1968 San Pablo Avenue Berkeley, California 94702-1612  |  Ph: (510) 548-2377  |  Fax: (510) 548-4051
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