Kendall County Mass Vaccination Volunteer Application
Name *
First and last name
Email *
Phone number *
Work Information
Occupation and Position *
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Education Information
Dates and Institution
Major and Degree
Served in the Armed Forces
Licenses/Certifications/Skills
License or Certificate/Registration Number
Are you licensed to dispense prescription medication?
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Are you licensed to administer medication?
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Languages Spoken *
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Availability
8:00 AM
9:00 AM
10:00 AM
11:00 AM
12:00 PM
1:00 PM
2:00 PM
3:00 PM
4:00 PM
5:00 PM
6:00 PM
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