Volunteer Application Volunteer Application Name* First Last Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* Emergency Contact* Contact's Phone*Skills or Training (Check all that apply) Accounting Administrative Computer Skills (Microsoft Office) Counseling (Credentialed) Event Planning Graphic Design Manual Labor Mentoring Multilingual(specify languages in Other Interests or Skills box below Photography Public Relations Public Speaking Reception Social Media / Internet / Web Writing Jobs You Would Like (Check all that apply) Committees Facilitator (Family Education) Facilitator (Support Groups) Grant Writer Helpline Library Mass Mailings Phone Work Public Education Assistant Tabling / Outreach Events Typing / Data Entry Interested in Helping With Special Project Night out with NAMI Fundraiser Harvest of Hope Conference Annual NAMIWalks Other interests or skillsHobbiesCertificates, licenses or degrees obtainedHow many days a week would you volunteer? How many days a month would you volunteer? Days you would be available to work (Type in Morning, Afternoon, or Evening as appropriate)Monday Tuesday Wednesday Thursday Friday Saturday Sunday Have you ever been convicted of a criminal offense, including sex-related or child abuse offenses:* Yes, I have No, I have not