Volunteer Application

CCCHC Volunteer Application

Fields marked with * are required

Optional
Email is the primary mode of contact for CCCHC. Text messages would be only for scheduling purposes or other urgent clinic business; for example, if we need someone to fill in for a late volunteer cancellation.
You must provide at least two references including relationship to you, phone number, and email for each.
You must provide at least two references including relationship to you, phone number, and email for each.
See descriptions of each area in the Volunteer Handbook and/or at http://ccchc2003.org/volunteer. You may choose more than one area. If there are MEDICAL QUALIFICATIONS listed by the area, you MUST have one of those to volunteer in that area! If you have no medical qualifications you can ONLY sign up for the areas listed as non-medical.