Thank you for your interest in volunteering for the Refugee Mental Health Resource Network, an APA Interdivisional Project. The purpose of our project is to create a network of mental health professionals to provide pro-bono services for refugee populations around the world. To sign up, we will need to collect your personal and professional information on our secure database through this form. Agencies and organizations looking for pro-bono services will be able to use the database to find professionals willing and able to assist. We will not release identifying information, other than what you have agreed to being published, nor will we sell your personal or professional information to any third parties. All storage and communication of your information will be encrypted by the database administrator.

Optional information marked Not for Publication (NFP) will be stored and used internally by the administrators and project manager.  This information will not be released to anyone outside of our project. If you do not want to provide this information, leave it blank and continue.

Submission of the application indicates consent to be included in the database.