Barry and Eaton Counties COVID-19 Vaccination Clinic Non-Medical Volunteer Sign Up Form
IF YOU ARE CERTIFIED TO ADMINISTER VACCINE OR ARE EMS OR OTHER MEDICAL PERSONNEL, please fill out medical personnel volunteer form which can be found on our website here:

Please fill out the following information completely if you are interested in volunteering at one of our COVID-19 vaccination clinics.
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Name *
Age *
Email *
Phone number *
Can we text you? *
County in which you are willing/ able to volunteer *
How many days per month are you willing/ able to volunteer? *
Although subject to change, morning shifts will range anywhere from 7am to noon, afternoon shifts anywhere from noon to 7pm.
We expect to receive enough vaccine to be able to vaccinate our volunteers.  We need to prepare for volunteer vaccinations and need to collect the following: *
Duties in which you are willing/ able to participate as a volunteer: *
Are you able to work "in the elements" (i.e. rain, snow, cold, etc.)?
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Anything else we should know?
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