Volunteer Registration Form

Name*
First Last
Pronouns*
How should we refer to you in the third person? Please check all that apply.
- They/them
- She/her
- He/him
- Any pronouns; I have no preference
- No pronouns; please refer to me by name only
- Other
Please specify your pronouns.
Email*
Phone*
Address*
City State / Province / Region Country
In what ways are you willing to contribute your time and talents?*
Check as many or as few as apply.
- Graphic design
- Emails
- Peer support
- Phone calls
- Shield campaigns
- Social media
- Translation/interpretation
- Visiting people at local psychiatric institutions
- Writing letters
- Web design
- Other
Please tell us a bit about yourself and your relevant skills/experience.*
0 of 2000 max characters

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P.O. Box 11284
Eugene, OR 97440-3484 USA

454 Willamette St., Suite 216
Eugene, OR 97440-3484 USA

Phone: (+1) 541-345-9106
Fax: (+1) 301-664-2980

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MindFreedom International is a tax-exempt nonprofit organization under section 501(c)(3) of the Internal Revenue Code.

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