Volunteer Interest Form

Health Brigade Volunteer Interest Form

Thank you for your interest in joining the Health Brigade team! Please answer the below questions so we can find the right volunteer opportunity for you.
Name

First Name Last Name
Email
example@example.com
Today's Date

Month Day Year
Are you over 18?

Yes No
What Programs are your interested in working with?

Medical Clinic Comprehensive Harm Reduction Spanish Interpretation HIV/STI Testing and Prevention Patient/Client Registration Medication/Pharmacy Program Administrative Support COVID Testing and/or Vaccination Mental Health & Wellness Other
What kind of commitment is right for you?

A one time event About once a month A few times a month About once a week A few days a week More than a few days a week
How many hours would you like to volunteer per week?

Less than 4 hours 4-8 hours 8-12 hours 12-20 hours 20-30 hours More than 30 hours
What is your availability?

Monday Morning Monday Afternoon Tuesday Morning Tuesday Afternoon Wednesday Morning Wednesday Afternoon Thursday Morning Thursday Afternoon Friday Morning Friday Afternoon
What languages do you speak in addition to English?
What special skills and talents are you looking to share with Health Brigade?
Do you require hours for a program you are involved in? If yes, please explain the requirements.
What would you like us to know about you?
Should be Empty:

Health Brigade Volunteer Interest Form