Mental Health America of Kentucky Volunteer Application
Name *
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Phone *
Your answer
Email *
Your answer
Is this volunteer experience for school credit? *
Volunteer Areas (check all you are interested in) *
Please describe any mental health training or background you may have. *
Your answer
Would you be willing to undergo a criminal background check? (MHA-KY covers the cost) *
In what geographic locations would you prefer to work? (We service the entire Commonwealth of Kentucky but our offices are in Lexington) *
Your answer
What days of the week and times would routinely be convenient for you?
Your answer
Describe other types of volunteer work you have done or are now doing.
Your answer
Is there a certain group of people you would like to work with? (i.e . youth, seniors, women)
Your answer
Please list 2 personal references with contact information. *
Your answer
Is there anything else you would like us to know about you?
Your answer
Please check the boxes that represent your skill level. (These skills aren’t necessary, the only skill we require is the desire to help those with mental illness and those that wish to improve their mental health)
Very good
Finance Skills
Office Skills
Marketing Skills
Microsoft Office (Word, Excel, Power Point, etc.)
Web design and management
Social media
Database management
Public speaking
Community affairs and knowledge
Writing proposals and reports
Volunteer supervision
Are there any other skills you have that you would like us to know about
Your answer
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