Covid Vaccine Angel Initiative Volunteer Sign Up

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Hello,

We are thrilled that you are interested in helping make appointments for seniors.

Due to an outstanding amount of volunteers joining our effort....WE ARE NOT CURRENTLY ACCEPTING NEW VOLUNTEERS.

Feel free to complete the form below and if we begin accepting volunteers again, we will be in touch with you.

Thank you very much for your interest. We truly appreciate it!

Email *

Name *

Please note that your contact information will be shared with our Committee and Team Leaders.

Phone Number *

Your ZIP Code *

Please provide the last 4 digits of your Social Security Number.

Please note that because you will be collecting sensitive personal data as part of your volunteering, the town requires this information. Access to these answers is restricted.

Please provide your ID Number (from a State Issued Driver License or Identification Card)

Please note that because you will be collecting sensitive personal data as part of your volunteering, the town requires this information. This is not for the purposes of transporting Seniors. Access to these answers is restricted.

Please provide the State who Issued your ID

Please note that because you will be collecting sensitive personal data as part of your volunteering, the town requires this information. Access to these answers is restricted.

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