RAC-G Volunteer Form
RAC-G is building a roster of volunteers from our retired medical community. Should the need arise we want to be ready and we thank you in advance for your willingness to serve.
Email *
Name: *
Email: *
Address: *
City: *
County: *
State: *
Cell: *
What is your discipline? (Nurse, EMT, Fire, ect. Include any specialties or certifications) *
Is is your license current? If not have you applied for the waiver yet? *
When would you be available? *
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