I AM WILLING TO VOLUNTEER
We are preparing for and limiting exposure of COVID-19 in the Clay Center community by identifying healthy adults who are under 60, whose risk factors are low and who are willing to volunteer for an elder or someone with high risk factors in our community. Once you have filled out this form you will be contacted on an as-needed basis and be responsible for coordinating the delivery of essential supplies, like food and prescriptions.

Please call Clay Center Area Chamber of Commerce at 785-632-5674 or email claycenterchamber@gmail.com with additional questions.
Name *
Your answer
Email *
Your answer
Phone Number *
Your answer
Street Address, City & Zip code *
Your answer
I agree to... *
Required
I am willing to help by... *
Required
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy