Volunteer Application NAMI Queens/Nassau Volunteer Application Name* First Last Mailing Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Home Phone*Work PhoneCell PhoneWhat is the best way to reach you?Home PhoneCell PhoneWork PhoneEmailText MessageEmail* Help raise awareness about mental illness, support the many programs and services we offer, and work with us for real change.Clerical/Office Work: Proficiency with standard office equipment such as fax and copy machines, multi-‐ line phone system and basic computer skills preferred. Help getting out mailings needed at times.Data Entry: Looking for people skilled in data entry in Excel and Quick Books. Accuracy a must.Speaker’s Bureau: Speak at schools, hospitals, community mental health agencies, and professional programs about NAMI and mental health issues. We will train you. Volunteers must demonstrate excellent communication skills, a strong grasp of NAMI’s philosophy and mission, and comfort in discussing their personal experience.Outreach: Distribute literature and/or table at libraries, schools, meetings, conferences, and community events.Walk Committee: Fundraise, solicit sponsors, distribute material, serve on a committee for Walk Day (food, registration, entertainment, set-up, etc.)Advocacy: Become familiar with state and national advocacy issues. Phone, email or speak to legislators locally or in Albany or Washington about our advocacy agenda.Specific Committee (see committee page)Relationship to Person with Mental Illness:SelfSpouseSignificant OtherMental Health Provider/ProfessionalParentChildConcerned CitizenHow often do you wish to volunteer and when are you available?How did you hear about NAMI Queens/Nassau?Employment, Education, & Special SkillsSpecial Skills & Talents: Bilingual Art (Photography, Graphic Design, etc.) Fundraising (Grant Writing, Event Planning, etc.) Office Skills (Phones, Copying, Organizing, etc.) Public Speaking IT Expertise (Website, Database Management, etc.) Computer Skills (Microsoft, Internet, typing, etc.) Strong “People Skills” CPR/First Aid Certified Training and Development EmployerOccupationEmployer My employer gives time off for volunteering My employer matches cash donations Highest Level of Education Completed:Degree/Major:Additional Training, Certifications, or Memberships:
