CMHA Volunteer Application Form

Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email

example@example.com

Phone Number

Please enter a valid phone number.

What is the best way to get in touch with you?

EmailPhone

Are you currently receiving services from our agency?

YesNo

Employment Status?

Employed Full TimeRetiredEmployed Part TimeNot Working

Describe your prior volunteer experiences, including organization names and dates of service

Share some of the skills and attributes you would bring to your volunteer position:

Tell us what you know about CMHA-Central Alberta Region and the programs and services we provide and why you are interested in volunteering with our agency:

Please indicate which areas you are interested in volunteering for. Check all that apply.

Clerical Support (filing, answering phones, photocopying)Special Events (Wellness Ride, AGM, Mental Health Awareness Week)Program / Practicum placementFundraising / Donations (sorted donated items, mail-outs etc)Board of DirectorsMarketingActivity Co-ordinating (bingo, board games, arts & crafts, community kitchen program etc)Other

Please indicate your availability (actual times may vary based on requirements of volunteer role)

	Morning only	Afternoon only	Evening only	Morning and Afternoon	Afternoon and evening	Morning and Evening	All day
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

References:

CMHA-Central Alberta Region may request personal references who know you well and can attest to your character, skills, and dependability, if necessary for certain volunteer roles.

Please read:

I understand that this is an application for and not a commitment or promise of volunteer opportunity. If accepted as a volunteer with CMHA-Central Alberta Region, in any capacity or for any length of time, I agree to abide by the policies and procedures of the agency. I agree that all the work I do is on a volunteer basis and I am not eligible to receive any monetary payment or reward.

I certify that I have and will provide information throughout the screening process, including on this application for a volunteer position and in interviews with CMHA- Central Alberta Region that is true, correct and complete to the best of my knowledge.

Signature