Volunteer

CHAMPS Volunteers are bringing new skills to the Mental Health Center of Denver! CHAMPS - Caring Hands and Minds Providing Support...

to the 2Succeed in Education and Employment programs
to A New Day Resource Center
to the Horticulture Therapy Program
as greeters for the Mental Health Center of Denver Recovery Center
to wherever your skill set leads you!

Do you want to be a CHAMPS Volunteer? The Mental Health Center of Denver would be happy to help you get started... Please fill out the information below:

For additional information, please contact Joanne Aiello, Manager of Event Planning and Volunteers at 303.504.6732 or joanne.aiello@mhcd.org.

C.H.A.M.P.S.

Volunteer Application form

Your name *

Home phone *

Home address *

Email address *

Your occupation *

Company/Business name *

Company/Business address *

Company/Business phone *

Your duties *

Educational background *

Community affiliations (churches, clubs, service organizations, etc). *

Previous volunteer experience (please describe) *

Please select from the following types of volunteer positions based upon your interest and experience: *

adult consumers

Child and family

Office work

Special activities (teaching a knitting class, taxes, computers, etc)

Hobbies, skills, and interests *

How many hours each week can you comfortably give? *

Please list your preferred days and times during the week when you might be able to volunteer *

Please list an emergency contact

Name *

Address *

Phone *

Relationship *

Family physician

Name *

Address *

Phone *

What are your personal/professional goals as a volunteer? *

References

Reference

Name *

Address *

Phone *

Relationship *

Reference

Name *

Address *

Phone *

Relationship *

Electronic signature

THIS ACKNOWLEDGEMENT FORM applies to the provisions of the federal Electronic Signatures in Global and National Commerce Act of October 1, 2000. AGREEMENT: By signing this Electronic Signature Acknowledgment Form, I agree that my electronic signature is the legally binding equivalent to my handwritten signature. Whenever I execute an electronic signature, it has the same validity and meaning as my handwritten signature. I will not, at any time in the future, repudiate the meaning of my electronic signature or claim that my electronic signature is not legally binding.

Signature *

Date *

Month

Day

Year

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Volunteer