1. Provide Your Contact Information
First Name
*
MI
Last Name
*
Street Address
*
City
*
State
Zip/Postal Code
Email
*
Invalid Email
Confirm Email
*
Invalid Email
Daytime Phone
*
Invalid phone number format. Should be (000) 000-0000
Evening Phone
Invalid phone number format. Should be (000) 000-0000
Are you a university student?
Yes
No
Are you under 18 years of age?
Yes
No
2. Pick Your Duties
Are you able to perform a blood draw?
*
Yes
No
Please list medical credentials if any
Primary Volunteer Duties: please check off any/all where you are able to help.
Medical Volunteer Duties: please check off any/all where you are able to help.
Do you speak a language other than English?
Do you have any other skills or talents?
3. Pick Your Fairs
I would like to help in the office. I am usually available on these days, during normal business hours:
Monday
Tuesday
Wednesday
Thursday
Friday
Morning
Afternoon
Fairs grouped by service area, chronological order.
Volunteer Standards Agreement
Please use this space to share any other thoughts/comments.
Electronic Signature: You acknowledge that the information you provided is correct and you agree to the terms of the Standards Agreement. Print your name and today's date below:
Please print this form for your records.
You will receive a confirmation two weeks in advance of the event(s). Should you need to cancel, please notify us right away so that we can find another volunteer. Thank you!
SUBMIT