Ambassador Program Application

Thank you for your interest in volunteering as a Starting Point Ambassador. As an Ambassador, you will play a key role as a liaison to the community. Not only will you share important information about mental health services at Starting Point, but you will play an active role in ending the fear and discrimination that often surrounds mental illness.

Please complete the following application and click the 'Continue' button at the bottom of the screen when you are finished. Once you have submitted your application, our Community Liaison will contact you with the next steps to beginning your journey as a Starting Point Ambassador.

Your Information

First name:

Last name:

Name to Appear on Name Tag:

Street 1:

Street 2:

City:

State:

* Zip: *

Home phone:

Cell phone:

Email address:

Age:

T-Shirt size:

Emergency Contact

First name:

Last name:

Street 1:

Street 2:

City:

State:

Zip:

Home phone:

Cell phone:

Email address:

Relationship:

Employer Information

Employer name:

Street 1:

Street 2:

City:

State:

Zip:

Work phone:

Email address:

Availability

Are you available to participate in outreach activities to include health fairs, festivals, community outreach and education events, city and/or county commissioner meetings and attend a minimum of 50% Ambassador Program quarterly meetings?

*Participation in Ambassador activities is subject to your availability. We will provide volunteer opportunities daytimes, evenings, and some weekends.

Confirmation of Availability:

Education/Training/Certificates

Please list any education, trainings or certificates you have acquired that may apply to this volunteer position. Please indicate if you have completed the Mental Health First Aid (MHFA) training course. If yes, please insert the certification date listed on your certificate.

MHFA Certified:

MHFA Date Certified:

Work/Volunteer Experience

Please summarize your previous work/volunteer experience that may apply to this position. Please also describe any political/civic appointments you have held and any boards/committees you have served on (i.e. business, civic, community, fraternal, political, professional, recreational, religious, and social) including the name of the organization, your title, and the dates of service.

Your Background

What education or skills could you contribute as an Ambassador? (Please check all that apply). You may use the comment box to describe any education or skills not listed or elaborate on any of the fields you checked.

Your Views on Our Organization

Please tell us about your interest in Starting Point and how you heard about the agency.

Your Contribution

Please describe how Starting Point would benefit from your involvement as an Ambassador.

Your Connections

Please list any groups, organizations, or businesses that you could serve as a liaison to on behalf of Starting Point.

Additional Information

Please tell us anything else you would like to share.

Acknowledgement

By submitting this application, you are demonstrating interest in joining Starting Point's Ambassador Program. In order to be eligible as a Starting Point Ambassador, you must:

1. Complete the Ambassador Program application and gain acceptance into the program.

2. Pass a Level 1 Background Screening.

3. Participate in and complete the Mental Health First (MHFA) Training.

4. Participate in and complete the Ambassador Program Orientation.

5. Participate in a team environment.

----------

PHYSICAL DEMANDS AND WORK ENVIRONMENT

The physical demands described here are representative of those that must be met by a volunteer to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the volunteer is regularly required to speak well or hear adequately. The volunteer frequently is required to stand; sit; use hands to finger, handle, or feel; and reach with hands and arms. The volunteer is occasionally required to walk; climb or balance; and stoop, kneel or crouch. The volunteer must frequently lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception, and ability to adjust focus. The volunteer may be required to perform some duties in the community (health fairs, schools/universities, government institutions, hospitals, etc.) and in an outside environment. Starting Point Behavioral Healthcare is an equal opportunity and drug free workplace and prohibits discrimination in all of its programs and activities on the basis of race, color, religion, national origin, gender, sexual orientation, marital status, age, veteran status, disability or genetic information. If you are a person with a disability who needs any accommodation, you should contact the office of our ADA Coordinator, 463142 SR 200, Yulee, FL 32097; VOICE (904) 225-8280, EXT. 448; FAX (904) 225-9125 or Email: info@sphb.org.

----------

POLICY

It is the policy of Starting Point Behavioral Healthcare to develop guidelines regarding the implementation of the Starting Point Behavioral Healthcare (SPBH) Ambassador Program. The purpose of this policy is to ensure that guidelines are in place and that all SPBH Ambassador Sub-committee members, SPBH Ambassador Program candidates, and SPBH staff are informed of the proper procedures regarding the inclusion of the SPBH Ambassador Program services. The SPBH Ambassador Program is a volunteer program that will provide services that advocate for the reduction of stigma related Mental Health/Substance Use Disorders (MH/SUD), and support SPBH staff and the Community Outreach and Education Committee members in an official capacity in the community. SPBH Ambassadors will be responsible for promoting SPBH services and initiatives both on community advocacy and legislative issues.

SPBH Ambassador Program Selection Process and Training:

1. Must complete and submit the SPBH Ambassador Program Application (online or in person)

2. Selected applicants will be invited and participate in an interview process.

3. Once accepted, the newly selected Ambassador will participate in the on-boarding process by H.R. and pass a local background screening.

4. The newly selected Ambassador will complete a complimentary Mental Health First Aid training (or provide a MHFA certificate of completion within the last three years).

5. The newly selected Ambassador will complete the Ambassador Program orientation.

SPBH Ambassador Program Orientation:

SPBH Ambassadors will participate in an orientation process to include SPBH history, current programs and services, boundaries and ethics, and review of the SPBH Ambassador Handbook

SPBH Ambassador Program Time Commitment:

Willingness and availability to participate in outreach activities to include: health fairs, festivals, community outreach and educational events, city and/or county commissioner meetings. Requires attendance at a minimum of 50% Ambassador Program quarterly meetings. **Participation in Ambassador activities is subject to the availability of the Starting Point Ambassador. Starting Point will provide volunteer opportunities daytimes, evenings, and some weekends.

SPBH Ambassador Program Supervision

A SPBH staff member will Supervise the Ambassador Program. All SPBH Ambassador Program candidates will be Supervised by a member of the Community Outreach and Education Committee or a SPBH staff member while facilitating an event, meetings prior to an event, and at the quarterly Ambassador Program meetings. This will promote competencies in all training information. Supervision will address: event performance, interaction with the public, ability to articulate the information, ability to work in a team environment, identification of concerning behaviors, issues of ethics and professional standards, including boundaries and appropriate sharing of life experiences, cultural competency issues (ability to work with and interact with all populations).

I Agree

Return to Main Site | Privacy Policy