Healthy Stores for a Healthy Community Volunteer Application
First name *
Your answer
Last name *
Your answer
Date of Birth *
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DD
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YYYY
In what city do you live in? *
Your answer
Zip Code *
Your answer
Phone Number (Mobile) *
Your answer
Alternative Phone Number
Your answer
E-mail Address *
Your answer
The Healthy Stores for a Healthy Community Campaign requires the use of a smartphone or tablet device to complete the survey. Please check which devices you own: *
Required
Please select the workshop that you will attend. *
Which organization are you affiliated with? *
How did you find out about this volunteer opportunity? *
Required
What type of gift card are you interested in? *
What are your reasons for wanting to participate as a "Healthy Stores for a Healthy Community" volunteer? *
Your answer
I am aware that if I am under 18 years old, it is required to have parent/guardian consent in order to participate as a volunteer. Not having a parent/gaurdian's signature will prevent me from participating in the program. *
Thank you for filling out the Healthy Stores for a Healthy Community Volunteer Application. You will be contacted shortly through e-mail. If you have any questions, please call Grace Dadios at (650) 573-2026 or e-mail gdadios@smcgov.org.
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