Grassroots Advocacy Volunteer Form

Tell us about yourself:

Are you a Veteran or a Non-Veteran?

Are you a spouse, partner, or family member of a Veteran?

What is your relationship status to your Veteran?

Are you one of these professionals?

Select all that apply. Hold the Command key (Mac) or Control key (PC) to make multiple selections.

Please share either your professional webpage, LinkedIn profile, or your personal social media weblink here:

Are you a Heroic Hearts Project or Hope Project retreat alum?

Are you affiliated with any of these organizations?

Select all that apply. Hold the Command key (Mac) or Control key (PC) to make multiple selections.

If Other, please enter here:

Personal Details

First Name

Last Name

Gender

Email

Phone

Birthdate

mm/dd/yyyy

Occupation

Address

Do you currently live in the Domestic US?

Street

City

State/Province

Zip/Postal Code

Country

Enlistment Home of Record

State You Currently Call Home

Your Military Service

Country of Service

Other Country

Branch of Service

Date Entered Service

mm/dd/yyyy

Date of Separation

mm/dd/yyyy

Separation Status

Which military operations have you participated in?

Select all that apply. Hold the Command key (Mac) or Control key (PC) to make multiple selections.

Other Operations:

Upload proof of military service document (DD214 for US Veterans).
Your application CANNOT be approved without this document.

Please provide a description of what happened during your military service which directed you towards using psychedelics for healing.

Your Veteran's Military Service

Country of Service

Other Country

Branch of Service

Is your Veteran currently active duty?

Professional Experience

Please describe your educational background, certifications, and experience with facilitating, coaching, or researching psychedelics.

If applicable, please list published papers or studies you have contributed to, including links.

Do you have experience working with the veteran population?

YesNo

Please explain your experience working with the veteran population.

Do you have experience speaking with media, politicians, or other external audiences?

YesNo

Psychedelic History

Do you have experience with psychedelics in a healing or therapeutic context?

Which of the following psychedelics have you used in this context?

Select all that apply. Hold the Command key (Mac) or Control key (PC) to make multiple selections.

5-MeO-DMT

In what capacity of use?

Date of last use

mm/dd/yyyy

Ayahuasca

In what capacity of use?

Date of last use

mm/dd/yyyy

Iboga/Ibogaine

In what capacity of use?

Date of last use

mm/dd/yyyy

Ketamine

In what capacity of use?

Date of last use

mm/dd/yyyy

LSD

In what capacity of use?

Date of last use

mm/dd/yyyy

MDMA

In what capacity of use?

Date of last use

mm/dd/yyyy

Peyote/San Pedro

In what capacity of use?

Date of last use

mm/dd/yyyy

Psilocybin

In what capacity of use?

Date of last use

mm/dd/yyyy

Please describe your experience(s) with psychedelics supporting your healing journey

Can you describe your integration experience so far? Please share how many sessions you’ve completed, any challenges you’ve encountered, and whether you’ve accessed additional mental health resources (e.g., therapy, peer support, coaching) along the way.

For HHP/Hope Project Alumni

Thinking back to your HHP/Hope Project Retreat, who was your coach?

Our veteran advocacy program includes additional coaching support for select volunteer opportunities.

If selected to support in these roles, would you prefer to continue working with your prior integration coach, or be matched with someone new?

Work with prior Integration CoachWork with new Integration Coach

Preferred Coach Gender

MaleFemaleDoes not matter

Thank You for Your Interest

The Volunteer Advocacy program is only available for residents of the Domestic United States who have used psychedelics in a healing or therapeutic context.

We appreciate your interest and invite you to reapply if your situation changes. Thank you!