VNF Mental Health First Aid Instructor Training Volunteer Interest Form

Volunteer Interest Form

Mental Health First Aid Instructor Training Opportunity

Thank you for your interest in volunteering with VNF! Please complete our form and a staff member will be in touch shortly.

Name:

First NameLast Name

Credentials (for example: DNP, MSN, BSN, RN)

Phone Number:

Area CodePhone

County:

E-mail Address:

Describe any relevant mental health professional experience:

This opportunity is the result of a grant awarded to the Virginia Nurses Foundation by the Robert Wood Johnson Foundation (RWJF) in support of VNF’s mental health initiatives. In compliance with RWJF, we request information from our applicants that will help insure diversity of perspectives and experiences.

The following are among those factors considered by RWJF and VNF.

Optional: Please include relevant information on any of the below lines that you feel apply to you.

Race:

Ethnicity:

Physical and mental ability:

Age (i.e., new or retired nurse):

Socioeconomic status:

Gender identity and expression:

Sexual orientation:

Education:

Religion:

Legal status:

Military service:

Virginia Poverty Rate by County

Please click the link to identify if you currently work or reside in an economically disadvantaged area of Virginia.

As identified on the "Virginia Poverty Rate by County" map, do you currently work or reside in an economically disadvantaged area of Virginia?

Please explain why you are an excellent candidate for this volunteer leadership role.

Please attach your résumé/CV.

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Additional thoughts/questions.

Applications will be reviewed by a committee on a rolling basis.