Mobile Migrant Health Team (Chicago) Volunteer Sign-up Form
Thank you for your interest in volunteering with us! 

Please fill out this form to be added to our volunteer directory and WhatsApp group. 
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First Name
Last Name
Institutional Affiliation (UIC, RUSH, etc.)
Phone Number
What is your current occupation? 
Clear selection
If you have dual licensing, or have other forms of certification please list here:
Level of Spanish Fluency
Clear selection
Do you know any language other than English or Spanish? (If not skip)
Do you have a car to help transport supplies & people?
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Potential Availability for Health Assessments
AM (9AM-1PM)
PM (2PM-6PM)
Evening (After 5PM)
Are you interested in being in one of our committees?
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