Adult/Student Volunteer Candidate Form

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Our mission is to help empower, strengthen and improve the mental health of children by providing professional, educational, and other resources to their families while navigating through the process of a divorce, incarceration, or loss of a parent.
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Name* This field is required.
First Name
Last Name
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Parent/Guardian Name (If Minor)* This field is required.
First Name
Last Name
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Your Email* This field is required.
example@example.com
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Your Phone Number* This field is required.
Area Code
Phone Number
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Birth Date* This field is required.
Date
Month
Day
Year
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Education Level* This field is required.
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
GED
Some College
Baccalaureate
Masters
PhD
Law
Other
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School Name* This field is required.
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Emergency Contact* This field is required.
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Briefly state why you wish to volunteer with us?* This field is required.
If you need to satisfy volunteer hours, please state for which organization, i.e. National Honor Society,
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Briefly list and describe any previous volunteer experiences. * This field is required.Example: ABC Hospital, Event Volunteer,-variety of tasks including set-up and break down.
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What skills or other interests should we know about?* This field is required.
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Choose an area of interest* This field is required.
Adult Workshops
Advisory Board Member
Brand Awareness(Social Media & Web Support)
Board Member
College Internships
Event Planning and Fundraising
Homework Assistance / Tutoring (high school/college students only)
MHFA Training
Newsletter
Panelist: The Education and MisEducation in Mental Health
Peer-to-Peer Support Groups
Podcast Guest: STIMTALK
QPR-Youth Suicide Prevention
Volunteer Recruitment
Youth Workshops
Where I'm most needed
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Availability Information* This field is required.
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Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
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Volunteer Candidate Signature* This field is required.
Clear
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Parent/Guardian Signature (if applicable)* This field is required.If over 18 of age, please N/A
Clear
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Terms and Conditions* This field is required.
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Thank You for your interest. We will be in touch!
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Follow us on Social Media!
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