Non-Medical Volunteer Form
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Are you 18 years or older?
*
Yes
No
Please select your general availability (check all that apply)
*
Weekday AM
Weekday PM
Weekends
Volunteer duties that interest you (check all that apply):
*
Canvassing (door to door)
Vaccination clinics (traffic control, registration, screening, etc.)
Comments that SCHD should know:
Submit
Should be Empty: