Volunteer Facilitator Intake - Nā Keiki O Emalia

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Nā Keiki O Emalia

Grief Support for Children and Teens

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Volunteer & Facilitator Intake Form

Name(Required)

First Last

Email(Required)

Phone(Required)

City State and Zip

City State / Province / Region ZIP / Postal Code

Do you currently live on Maui?(Required)

Yes

No

Somtimes

How Long have you lived on Maui. Have you lived anywhere else?(Required)

Further explanation about residence

1. What draws you to wanting to become involved with Nā Keiki O Emalia and providing support to grieving youth and families?(Required)

2. Do you have any experience with grieving children, teens or families?(Required)

3. Are you interested in becoming a group facilitator?(Required)

Yes

No

Maybe

If interested in facilitating direct them to the Facilitator link on our website menu under "How You Can Help"

There they can:

Get general information about facilitating

Sign Up for Monthly Zoom Facilitator Enrichment Training hosted by different experts each month

Sign up for Online Grief Group Facilitator Training Courses

Sign up for an In-Person Intensive 2-day Training

4. Please share your past volunteer experiences. What did you like the most and least about these experiences?(Required)

5. Have you had any personal experiences around grief and loss in addition to the personal and collective losses we have all faced since the Maui wildfires?(Required)

6. What roles are you interested in most? (Note: this info should be in their original application)

Support Group Facilitation in Schools

Support Group Facilitation in Community Centers

Facilitator Mentor (must have training)

Volunteer Leader

Community Outreach

Compassion Calls

Helping at Events

Keiki Care Package Program

Office Admin

Videography

Social Media

Marketing

Other

Other Role

7. Do you have specific skills, you'd be enthusiastic about sharing with our organization?(Required)

8. How much time are you able to commit on a weekly/monthly?(Required)

9. Are you looking for a short-term (e.g., a few weeks or months) or long-term (e.g., several months to a year or more) volunteering opportunity?(Required)

10. Are you comfortable working independently or do you prefer to work in a team?(Required)

Teams

Independently

Both

What age groups are you comfortable or interested in working with?

Littles

Middles

Teens

Adults

No Preference

The following questions are voluntary, but will help us know best how to place you.

How familiar are you with Hawaiian culture?

Are there any other cultures that you are familiar with?

Do you speak any other languages (including sign language) than English? If so, would you be interested in translating?

11. We require background checks for all our volunteers. Are you willing to have a background check at no cost to you?(Required)

Yes

No (explain Below)

Needs further discussion - Explain Below

Notes on background check

12. Do you have any physical or health limitations we should be aware of?(Required)

13. How did you hear about our organization and the volunteer opportunities we offer?(Required)

14. Anything else that you would like to share that would be important or helpful for us to know about you?

Qualified Volunteer? Cleared to request background check?(Required)

Yes

No (explain below)

Needs further discussion (explain below)

Further Information Regarding Background Checks

Interviewers Private Notes - Observations

Name and position of interviewer (click plus to add more than one)(Required)

Interviewer

Position with NKOE

Qualified Facilitator? Cleared to send to Facilitator Intake(Required)

Yes

No longer interested in facilitation

No (explain below)

Needs further discussion (explain below)

Facilitator Intake Notes

Date

MM slash DD slash YYYY

If cleared for or not sure of Facilitation Intake scroll down the page click: Save and Continue

If cleared: Forward link to kim@nkoemaui.org

If not cleared: forward to katie@nkoemaui.org

If no more is needed to be done scroll down and choose 11 and click Submit

------Facilitator Intake Starts Here------

Are you interested in attending an In-person facilitator training?

yes

No

Maybe

1. What draws you to wanting to become involved with NKOE and providing support to grieving youth and families?

2. Have you had any experience working with children or teens, grief and loss and/or group facilitation? If so- in what capacity?

3. Have you had any personal experiences around grief and loss in addition to the personal and collective losses we have all faced since the Maui wildfires?

4. How have you navigated and cared for yourself regarding your own personal grieving process?

5. What are your strengths and areas of improvement around the possibility of being a grief group facilitator for children, teens and/or their families?

6. Do you have specific skills, teachings, methods, or activities that you'd be enthusiastic about sharing with our organization and/or the facilitated groups?

7. Can you make a commitment to completing the online learning modules and attend each day of the in-person training?

8. If you do become a facilitator at NKOE can you make a commitment to attend each support group you commit to consistently and responsibly (apart from unforeseen or anticipated circumstances)?

9. Are you open to both giving and receiving constructive feedback during training, support group sessions, and in our pre/post-meeting discussions?"

11. Have you registered for the online facilitator training course?

Yes

No

10. Are you aware that we require you finish the first 4 modules of the online training before attending an in-person weekend intensive?

Yes

Not yet

If they have not registered, please inform them that they can easily register for the course.

They can do so by navigating to the "How You Can Help" menu on the website, followed by selecting "Facilitator" and then "Online Facilitator Training."

Once the registration process is complete, an email containing detailed instructions on how to log in and commence the course will be sent to them.

12. Anything else that would be important or helpful for us to know about you?

Cleared to do Keiki Lite?

Yes

No (Explain below)

Needs further discussion (explain below)

Cleared to proceed to in-person intensive?

Yes

No (Explain below)

Needs further discussion (explain below)

Further Explanation

Interviewer Private Notes - Observations

List

Name of Interviewer

Position

If no more is needed to be done choose 11 and click Submit

I am not a robot - Please answer 9 + 2 before submitting(Required)

11

98

76

Email

This field is for validation purposes and should be left unchanged.

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Contact

Cameron Center
95 Mahalani St – Room 10
Wailuku, HI 96793

Mail:
PO Box 1137
Wailuku, HI 96793

Phone:
(808) 214-9832

Email:
contact@nkoemaui.org

Nā Keiki O Emalia is a
501(c)(3) nonprofit organization
ID 47-3859477

Helping Children Heal

© Nā Keiki O Emalia 2014-2023 • All rights reserved