*Please note: This form is for CCI volunteers only. Please visit https://whatcomcovid.com/volunteer/ for other volunteer opportunities, including opportunities for licensed medical personnel.
Check all that apply.
Check all that apply:
· I am over 60 years of age.
· I have chronic lung disease or moderate to severe asthma.
· I have serious heart disease.
· I am immunocompromised. including cancer treatment.
· I am pregnant.
Please check only one box below.
I hereby certify that the facts set forth in this volunteer application are true and correct to the best of my knowledge. I agree that if the information given in my application or any other materials, or during any interview, is found to be false in any way, it shall be considered sufficient cause for denial of volunteer status. I understand that Whatcom County Health Department (WCHD) is not obligated to appoint me to a volunteer position and that nothing contained in the volunteer application form is intended to create a contract between WCHD and me. I agree to comply with all policies, rules, regulations and procedures of WCHD, which I understand may change at any time; and I understand that my volunteer status can be terminated with or without cause or notice, at any time, at the option of either me or WCHD.
This field is not part of the form submission.
* indicates a required field