Volunteer Application NAMI Queens/Nassau Volunteer Application Name* First Last Mailing Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe 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:
