Apply to be a Volunteer If you are interested in volunteering at CMHA Middlesex, please fill out the form below. Our team will be in contact with you to discuss opportunities! Volunteer Application Name * Required First Last Address * Required 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 Email Phone * RequiredSecondary PhoneHow do you prefer to be contacted?PhoneEmailAre you 18 years of age or older?YesNoEmergency ContactEmergency Contact Name * Required First Last Emergency Contact Phone * RequiredEmergency Contact Email Relationship:AvailabilityPreferred times for volunteering. * Required Monday Morning Monday Afternoon Monday Evening Tuesday Morning Tuesday Afternoon Tuesday Evening Wednesday Morning Wednesday Afternoon Wednesday Evening Thursday Morning Thursday Afternoon Thursday Evening Friday Morning Friday Afternoon Friday Evening I am only available on weekends. Skills and InterestsYou are welcome to upload your cover letter and/or resume here. Drop files here or Accepted file types: doc, docx, pdf, jpg, png, gif. Maximum file size - 10 mega bytes. Allowed file extensions - doc docx pdf jpg png gif. Indicate which volunteer activities you are interested in One-to-one My Sisters' Place Support Line Special Events Ride Don't Hide Driver West Middlesex Drivers Impact Junk Warehouse Assistant Strathroy Leisure and Life Skills Program Volunteer Administrative Mind Full Nest Gardener Peer Supporter London Stay Residential Support London Coffee House List skills, hobbies or interests that you have:List training or certifications that you have:Previous Experience (Paid and Volunteer)Previous Experience * RequiredOrganizationDutiesFrom (MM/YY)To (MM/YY)Add or remove row Please list past paid or volunteer experiences.ReferencesPlease provide three references. One must be a professional reference.References * RequiredReference NameAddressPhone NumberEmail AddressRelationshipAdd or remove row AcknowledgementDeclaration * Required I agree I declare that the information provided in this application is truthful, complete and correct. I authorize the Canadian Mental Health Association Middlesex to contact individuals or organizations I have named on this application to obtain further information that would assist with my placement as a volunteer. The information on this application form is collected under the authority of the Freedom of information and Protection of Privacy Act, and will be used solely for the purpose of determining eligibility and suitability for volunteer opportunities.