Volunteer Interest Form
Hello and thank you so much for your interest in volunteering with the Oral Health Collaborative Consortium and UCLA School of Dentistry! We are very grateful for your time! Please fill out the following form so we can contact you. Thank you!
What is your name?
What is your email address?
Please write in the event you are interested in volunteering for. (If not interested in specific event, just write interested in any OHCC event)
Ideally, what area of L.A. would you prefer to volunteer in? (Check all that apply)
SPA 1- Antelope Valley
SPA 2- San Fernando Valley
SPA 3 - San Gabriel Valley
SPA 4- Metro LA (DTLA)
SPA 5 - West LA
SPA 6 - South LA
SPA 7- East LA
SPA 8 - South Bay and Long Beach
What is your job title?
Are you currently working?
Are you a student?
If you are a student, where and what do you study?
Please name any professional organizations you belong to below.
What languages are you fluent in?
What would you be willing to volunteer for?
Provide oral health education at community events
Give a presentation about a dental specialty
Offer dental screenings
Can we contact you directly for future events to see if you are interested in volunteering again?
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