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.

    volunteers make a difference!

    Volunteering is a great way to help others in need, make a community impact, meet caring people, and develop useful skills that will serve you throughout your professional and personal life. Our training program is based on mental health needs and effective practices as established by national accrediting organizations. Individuals who successfully complete the training program will have the necessary skills to provide compassionate help to anyone in need of emotional support.  

    MHA Crisis Specialists provide a vital service to our community.  If you are considering joining our dedicated team of volunteers, please apply via the "Volunteer Application" button at the bottom of the page. Our next training dates are listed below.  All sessions are virtual (except the graduation party which is held at Mental Health America - Wabash Valley Region).  

    Registration for our fall training is full. Check back later for upcoming winter training dates.

     

    For any questions, please email Jessica Joya, Volunteer Coordinator at [email protected]

    Volunteer Application