Help patients register to vote
Volunteer onsite at our Clinics and help our patients and community patrons register to vote. This is a short term but very important volunteer role. You will assist in voter registration using both the online and physical forms. We will provide a training and guidelines detailing effective methods to assist anyone who is registering to vote.

There are multiple shifts at two of our sites and we have a max capacity of 3 volunteers per shift (see below for dates and times available). Please complete the form to register to volunteer.

To ensure the safety and well-being of volunteers, patients, and community patrons we are implementing the following safety measures:

All volunteers must wear a cloth face covering
We will provide disinfecting wipes and hand sanitizer
We are adhering to social distancing guidelines

VENICE FAMILY CLINIC LOCATIONS:

SIMMS/MANN Health and Wellness Center
2509 Pico Blvd. Santa Monica, CA 90405

Irma Colen Health Center
(Braddock Shopping Center)
4700 Inglewood Blvd. Los Angeles, CA 90230

Sign in to Google to save your progress. Learn more
Email *
Your Name (First and Last):
Phone Number (ex. (555) 555-5555): *
Are you a current/previous Venice Family Clinic Volunteer?
Clear selection
Affiliation (corporate, school group, etc): *
Please select a shift you are available to volunteer for (*Maximum capacity of 3 volunteers per shift*): *
Required
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy