volunteers make a difference!

Thank you for your interest in volunteering for MHA. Our Crisis Intervention Specialist volunteer opportunity is full for the March class. We will begin accepting applications for the next class towards the end of May.

    Is your current address the same as your permanent address?
    YesNo

    Date of Birth

    Sex
    MaleFemaleNon-Binary


    Work and Volunteer Experiences
    Please list your most recent work and volunteer experiences

    Start Date

    Start Date

    Start Date


    Education

    Are you presentely a student?
    YesNo

    Does volunteering fulfill a course requirement?
    YesNo

    Please Describe the Course Requirement



    Criminal History

    Have you ever been arrested?
    YesNo

    Have you ever been convicted of a crime?
    YesNo

    Do you give us permission to check this information?
    YesNo



    Personal Information

    Program Interests (required)
    AdministrationCrisis Center"I'm Thumbody Special"Health FairsSupport GroupsOther

    Why are you interested in volunteering for MHA? (required)

    What experiences, hobbies, skills do you have which might help MHA? (required)

    Please list your community interest or groups with whom you are affiliated



    References

    Please list three local references who we may contact.

    Reference #1

    Reference #2

    Reference #3

    I authorize Mental Health America to contact my references that I have provided above, and to inquire about my volunteer candidacy. The above-named persons are aware that Mental Health America will contact them and MHA has my permission to discuss any relevant information.



    Emergency Contact



    Verification

    By signing my full name, I hereby certify that the information on this application is accurate and complete to the best of my knowledge.