JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Herbal Medics Membership Interest
Please let us know about yourself and your interests so that we can get to know you more!
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Name
Your answer
Phone number
Your answer
City
Your answer
State
Your answer
Best way to reach you?
Phone
Text
Email
Clear selection
Facebook (so we can friend you!)
Your answer
Instagram (so we can follow you!)
Your answer
What is your interest in Herbal Medics?
Your answer
Would you like to participate online or in person
Online only
In person
Both
Clear selection
What type of work do you have experience or interest in?
Administration (phone, emails, etc)
Apothecary (medicine making & inventory)
Membership (group communication, organizing in-house events)
Outreach & Advertising (marketing, email campaigns, fliering)
Social media (content creation & management)
Workshops & Events (event coordination, recruiting instructors, teaching)
Website Management (online management of group content)
Other:
What is your herbal interest or education? (none is required)
Your answer
How do you feel you could contribute? (Knowledge, resources, skills, or just excited & interested in helping with whatever you can)
Your answer
Can you commit to 4 hours per month minimum?
Yes
No
I can do more!!!!
Clear selection
Send me a copy of my responses.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This content is neither created nor endorsed by Google. -
Terms of Service
-
Privacy Policy
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report
