Volunteer App - Advocates For Mentally Ill Housing

ADVOCATES FOR MENTALLY ILL HOUSING

VOLUNTEER APPLICATION FORM

This application asks you to describe the skills and experience you would like to offer Advocates for Mentally Ill Housing. Think about your role in service activities, membership in community organizations, academic experiences and personal talents. Take into account everything from your past and present. Your application and personal references help create a full picture of you and what you can bring to Advocates for Mentally Ill Housing. Make sure that this application accurately reflects all the qualities that make you a good candidate for volunteer and/or Board member.

Member Profile:

Name:_____________________________Date:

Social Security Number:e-mail:_

Date of Birth:_______           Sex:   Female_ Male_

Home Phone: _Cell Phone:

Address:__________________________________

Emergency Contact:Relationship_Phone:

Are you a U.S. Citizen or a Permanent Resident Alien? Yes   No

Have you ever been convicted of a crime in an adult court? _Yes _No

If yes, please explain:__________________________________

How did you learn about Advocates for Mentally Ill Housing?_

What is your method of transportation? _own car _bus _other, please specify__________

Do you have any special needs that require accommodation? _Yes _No

Personal Statement: Please answer the following on an attached sheet

1.       Why do you want to join Advocates for Mentally Ill Housing?

2.      What are your most important skills or experiences that will help you contribute to Advocates for MentallyIll and their housing needs?

3.      Describe what you think are the two most pressing problems in our County in relation to those who suffer from mental illness?

Community Activities: List and describe your organizational memberships and community-based service experience. Include social, professional, and neighborhood projects and programs.

Name of Group or Organization                            Description of Activities/Position

Education Background:

_High School Graduate   __Some College/Technical School_ Associate Degree__

Professional Degree _    GED Less than high school

Employment Record:

If currently employed, name of Organization:________

Job title:

References:   Please provide at least two people whom we may contact as references.

Name:Phone Number:

Name:_Phone Number:_____

Skills:

Administrative Support_Make copies, return phone calls, create documents and flyers, etc.

Advisory Panel _Provide input on ways to better serve those with mental illness

Community NetworkingParticipate in community meeting, events, partner organizations

Education/SchoolsMake presentations to local school districts on AMIH’s services/mission

FundraisingSeek out potential fundraising partners, assist in developing campaigns

Foundation RepresentativeSeek out foundation organizations that match AMIH’s mission.

Grant Writing_Assist in research, development, and production of grant requests

Investment Representative Seek out potential land acquisitions for lease/ownership by AMIH

Legal Services____Assist in researching legal organizations for pro bono work

Legislative/Advocacy_Research and track current State/Federal Legislation relative to funding

Mailer Assembly____ Assimilate materials, prepare for mailing, stamp and mail

Marketing/PR/MediaDevelop contact list of local media and distribute marketing packages

Newsletter Production_Develop, maintain, distribute quarterly on-line newsletter

Special Events _____Assist in planning, preparation, organization of special events

Strategic PlanningUpdate and review annually organization’s Strategic Plan

Telephone Caller_Make phone calls to remind volunteers of their upcoming commitment

Veterans’ ServicesInterface with County and community based Veterans’ service groups

Volunteer CoordinatorRecruit and manage core volunteers. Assist in annual recognition event.

Time commitments vary greatly for each.

I was referred to volunteer by:_______

My previous volunteer experience includes:

Today’s Date:

Signature:_

For more information contact: Becca Bettis, Operations Manager (916) 591-9149 e-mail: advocatesformentallyill1@gmail.com.

Please return this application to Advocates for Mentally Ill Housing Address: P.O Box 5216 Auburn, Ca 95604