Community Engagement Committee Recruitment Form | Mood Disorders Association of Ontario

Full Name: *

Pronoun: *

She/Her

He/His

They/Their

Other (please specify below)

Other:

Date of Birth : *

Email Address: *

Phone Number: *

If you have participated in MDAO groups, one-to-one services or other MDAO programming as a client/participant, have at least 6 months passed prior to completion of this application?: *

Yes (at least 6 months has passed since I received services from MDAO)

No (I have received MDAO services within the last 6 months)

Not applicable (I have never received services from MDAO)

I am currently an active MDAO Volunteer: *

Yes

No

Briefly describe why you are interested in getting involved with MDAO's Community Engagement Committee: *

Briefly describe experiences you've had in coordinating and executing community events. What did you find challenging about these experiences, and what did you enjoy?: *

MDAO is keen to be able to expand our presence within the community. Briefly describe some ways in which you may be able to assist in developing engaging and effective community displays: *

Do you have experiences working with diverse populations, and are you comfortable working with individuals that identify with having mental health challenges?: *

We are hopeful to be able to assemble a committee that is dedicated to ensuring MDAO's events are well executed, and our presence in the community is well represented. How many hours a week do you anticipate being able to dedicate to the committee?: *

Please note that the MDAO office is located at 36 Eglinton Avenue West, near the intersection of Yonge St. and Eglinton Ave.

A police records check is required to volunteer with MDAO. Are you willing to have a police record check completed?: *

Yes

No

Is there anything else you'd like to tell us?: