MANI Volunteers sign up Form
Mentally Aware Nigeria Initiative (hereafter referred to as MANI) is a non-profit organization
focused on raising awareness on mental health and illnesses as well as working to connect
service users to mental health professionals. MANI was founded and registered in Nigeria in
December 2015 with the Corporate Affairs Commission (CAC/IT NO 83725) but was officially
launched on the 11th of June 2016 by a team of young doctors and concerned individuals led by
Dr. Victor Ugo.

Rest assured that all the information provided here will be confidential and will not be shared with any other entity.

Please make sure to fill this form appropriately, as due to the large number of applications we have to deal with, we may or may not contact you to refill and your application will not be considered.

Also, due to the high influx of applications received, please do allow one month from when this form is filled to when you can expect to hear from us.

Thank you for your application.

Email address *
ABOUT YOU
This section is about You! We want to find out basic details about you, your skills and your contact details
Full Name *
Your answer
Sex *
Birthday *
MM
/
DD
Phone numbers *
All your numbers (Please indicate the WhatsApp active one with a (!) after the number).
Your answer
State *
Address *
Your answer
Emergency contact (Name and Phone number) *
Your answer
Twitter handle *
fill in, NIL, if you don't have any.
Your answer
Instagram handle *
fill in, NIL, if you don't have any.
Your answer
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service