Volunteer Information Form

Volunteer Information Form

This work takes a whole-community approach and we're always looking for assistance in key technical, administrative, mental health and other roles. Fill out the form below to get involved in our volunteer network today!
YesNo
Thank you for considering investing your time and skills in Life After Hate. At this time, we are unable to accept volunteers under the age of 18.
Contact Information
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
What city/state do you reside in?*
Background and Experience
Please select your highest level of education completed.*
Please list your current occupation. *
Ex: Healthcare, NGO, IT, etc.
YesNo
Please describe your previous volunteer experience below.
Volunteer Preferences
What is your availability? *
YesNo
What volunteer role are you interested in?*
What administrative experience do you have?
Examples: General office management, scheduling, data entry, etc.
Prospect ResearchDatabase ManagementEvent PlanningOther
IT - GeneralForum-Building/SupportWebsite-Building/MaintenanceOther
YesNo
What is the highest degree you have earned in the mental health field?
How much field experience have you accumulated?
YesNo
What areas of mental health do you specialize in?
Examples: Axis 1, Axis 2, etc.
What type(s) of treatment do you specialize in?
Examples: Psychoanalysis, hypnotherapy, etc.
YesNo
Yes, I currently work in a facilityNo, I have never worked in a facilityI previously worked in a facility
Other Important Information
How did you hear about Life After Hate and/or ExitUSA™?*
Examples: Media interview, presentation, etc
Have you encountered or are you familiar with Far-Right Extremism?*
If yes, please provide some detail describing your experience.
YesNo
YesNo
Should be Empty:

Volunteer Information Form

Contact Information

Background and Experience

Volunteer Preferences

Other Important Information