Advocacy Day/Screenings at the Capitol Volunteer Sign Up
Name
*
First Name
Last Name
MD, DO, Other
*
Email
*
example@example.com
County of Residence
*
I am interested in volunteering my time for the
*
Legislative visits
Screenings for the public
Either
Both
Have you ever participated in an Advocacy Day before?
Yes
No
Describe your experience with Advocacy Day:
Choose your preferred volunteer time. Volunteers will receive lunch regardless of time slot chosen.
9:00 am-12:00 pm
12:00 pm-3:00 pm
All Day
What sparked your interest in participating in Advocacy Day?:
Submit
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