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Click To Empower. Brought to you by The Allstate Foundation.

Tennessee's Annual Victim Assistance Academy
"Where Education Equals Empowerment"


July 15-20, 2007
University of Tennessee at Chattanooga
Chattanooga, Tennessee

APPLICATION DEADLINE: June 8, 2007

The Tennessee Coalition Against Domestic and Sexual Violence (the Coalition) is a non-profit organization composed of diverse community leaders and program members who share a common vision of ending violence in the lives of Tennesseans through public policy advocacy, education, and activities which increase the capacity of programs and communities to address violence.

Our services include: technical assistance, training, curriculum and resource development, public policy advocacy, newsletter publication, networking opportunities, resource library, speaker's bureau and a toll-free information line. As a statewide coalition, we serve domestic violence and sexual assault programs, community groups and organizations, criminal justice agencies, victim services agencies, allied professionals (medical, legal, mental health, etc.) and individuals seeking information and resources.

The application deadline is June 8, 2007. Applicants will be notified of acceptance no later than June 15. Use the form below to sign up online, or click here to download a printable application.

Applicant Name: Organization:
Mailing Address: Daytime Phone:
Evening Phone: Fax:
EMail: Web Site:
Current Position: County or Counties Served:
Number of years in direct victim services: Are you:
GED/HS Diploma/Associates/Bachelors/Advanced Degree(s)
Degree 1: Year:Major: School:
Degree 2: Year:Major: School:
Degree 3: Year:Major: School:

Please list any other training certificates received:


If accepted, I am interested in receiving information on obtaining academic, professional credit, or certification:
Undergraduate credit hours from the University of Tennessee at Chattanooga (fee of $350)
Graduate credit hours from the University of Tennessee at Chattanooga (fee of $400)
CEU professional credit hours (fee of $15.00) - (area of study):
P.O.S.T. credits
National Organization for Victim Assistance provisional credentialing (fee of $100)


NOTE: Students seeking academic, professional credit, or certifications are responsible for paying the course cost in addition to the general $350 registration fee.

Select the jurisdiction that best describes the type of organization you represent:
Federal State City County Private/Nonprofit Other

Your agency primarily serves clients in which type of community:

Select one category that best describes your organization or agency:


Indicate the types of crime victims that you primarily serve (check no more than three):
All Crimes Against Persons Drunk Driving All Crimes Against Property
Assault Bias Violence/Hate Crimes Child Abuse/Sexual Abuse
Computer Crimes Dating Violence Domestic Violence
Elderly Victims Gang Violence Missing/Exploited Children
Robbery/Theft Sexual Assault Survivors of Homicide Victims
Victims with Disabilities Other


Indicate the types of services that you primarily provide for victims of crime in your current position (check no more than five):
Assistance with Orders of Protection Medical Advocacy Case Management
Child Care Community Education Court Advocacy
Crime Victim Compensation Assistance Crisis Intervention Crisis Line
Emotional Support Individual Counseling/Therapy Information/Referral
Legal Advocacy Notification Restitution Assistance
Shelter Social Services Advocacy Support Groups
Systems/Institutional Advocacy Therapy/Psychological Counseling
Training and Technical Assistance Transportation
Victim Impact Statement Assistance Other

Please list affiliations with professional organizations or groups related to victim services:

Please mark your T-shirt size.




 

 

If you are in immediate danger, call 911. For resources in Tennessee call 1-800-356-6767 or 1-800-799-7233 (National Domestic Violence Hotline).

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