JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Get Out the Vaccine Volunteer Form
We have moved our signup! Please click this link to register!
https://secure.everyaction.com/LUg-bTvLOUCEh8wUd9K2Zw2?fbclid=IwAR1yUWY8fFFK7LBjmHrigkFQ_oUM-NJAWSRIdjq8r8jf6rhFJG0zXl_ghYU
To sign up for phone bank slots:
https://dayonerelief.org/phonebank/
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Volunteer name
*
Your answer
Primary phone number
Your answer
City
*
Your answer
County (if known)
Your answer
State
*
NC
Other:
I would like to volunteer to:
Make phone calls
Donate supplies/food
Recruit volunteers
Are you bilingual? (English/Spanish)
No
Yes, can hold a conversation
Yes, fluent
Clear selection
How did you hear about us? If you were referred by a friend, church, or organization, enter their name here.
Your answer
I am willing to volunteer in person at vaccine sites (traffic, transportation, etc.)
*
Yes
No
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms