Volunteer Application

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    Emergency Contact

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    Previous Volunteer Experience

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    Please list three professional, academic, or personal references, not relatives, whome we may contact

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    I certify that all information presented is true and correct to the best of my knowledge. I understand that if I have provided false information or misrepresented myself that could be a cause for not being accepted as a volunteer or for being dismissed and do give consent and permission to serve as a Volunteer for NAMI Lexington. I understand that I will be performing volunteer services as a Volunteer and that the volunteer services will be performed at the NAMI Lexington office or at events /venues held by NAMI Lexington. I know of no reason, medical or otherwise, that would me from performing the volunteer services as described. Except where resulting from the negligence of the NAMI Lexington or of NAMI Lexington‘s employees. I release and hold harmless NAMI Lexington for any loss, damage, or injury that may be sustained by me while I am serving as a volunteer for NAMI Lexington. I will hold harmless and indemnify NAMI Lexington as to any claims or actions brought by a third party arising out of my own negligence while serving as a volunteer for NAMI Lexington. I give permission and consent for NAMI Lexington, through its employees, to obtain necessary emergency medical care or treatment for me, if and when needed. I will honor the direction of NAMI Lexington, through its appropriate employees, to suspend or terminate my volunteer service. In signing this, I acknowledge and represent that I am eighteen 18 years of age or older.
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    NAMI Lexington is a grassroots, support, education, peer to peer and advocacy organization. Therefore, the bulk of our services and programs are run by family members and mental health consumers for other family members and mental health consumers. NAMI Lexington requires you to attend a 90-minute Orientation before starting you Volunteer assignment with our organization.