Volunteer Application

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Required format:

m6hQELbIWkXKFpRBswAiGak9PdRdLKRAFheMBHZ9uhGBcNcwPAYqZ5iQvNuP3pGhJKIWgkPI5jE9TaIcyBrgBLtgehmJSwdsUY6Qfgim

Thank you for applying to be a Real Voices Real Choices volunteer committee member. Your application will be reviewed by the conference coordinator, Kailey Reeves. Once reviewed, Kailey will reach out to you with any additional questions and to inform you if you have been selected to join the committee.

Please note, having transportation to and from the committee meetings in Jefferson City throughout the year and to the conference in August is a requirement to be on the committee.

If you have any questions regarding the application, please reach out to Kailey at Consumerconference@dmh.mo.gov

First Name:		Last Name:
Street Address:
City:	State:		Zip Code:
Phone:
Email Address:

Are you currently working?

* must provide value

Yes

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Will your employer be supportive of time away from your job to serve as a Committee volunteer and on-site Conference volunteer?

* must provide value

Yes

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Do you have transportation to attend the on-site meetings in Jefferson City, as well as to attend the annual conference?

* must provide value

Yes

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Have you attended a Real Voices-Real Choices Conference?

* must provide value

Yes

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How many Real Voices-Real Choices Conferences have you attended?

* must provide value

What position are you applying for?

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Developmental Disabilities (DD)

Mental Illness (MI)

Substance Use Disorder (SUD)

Family/Youth

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Why are you interested in volunteering?

* must provide value

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Summarize special skills and qualifications you have acquired from employment, previous volunteer work, or through other activities, including hobbies or sports that you feel would be beneficial for the Real Voices Real Choices Conference.

* must provide value

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Summarize your previous volunteer experience.

* must provide value

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First Name:
Street Address:
City:	State:	Zip Code:
Phone:
Email Address:

First Name:
Street Address:
City:	State:	Zip Code:
Phone:
Email Address:

First Name:
Street Address:
City:	State:	Zip Code:
Phone:
Email Address:

By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted as a volunteer, I will be required to attend in person meetings in Jefferson City and participate via phone for conference planning calls. I also understand that by submitting this application, I have not yet been selected to participate on the committee.

Signature:

Date:

It is the policy of this organization to provide equal opportunities without regard to race, color, religion, national origin, gender, sexual preference, age, or disability.

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