Please complete this application form if you are interested in becoming a Mission Medical volunteer. Once you complete the form, click the Continue button at the bottom.
You may optionally provide the following information. It is used only to help us get a better idea of the demographic make-up of our volunteers.
What are your skills and strengths? In what areas do you have experience?
If you are a medical professional, what type of licensure do you have?
Please indicate the days and times you are usually available to volunteer.
The following volunteer assignments may currently be available. You may click the assignment names to learn more about that assignment. Use this list to rank your top three assignment choices.
Please list your current or most recent employer, if applicable.
In the event of an emergency whom should we notify?
We like to keep volunteers informed of important news, schedules, and volunteer opportunities by email, however will not send you any email you prefer not to receive. Use the checkboxes below to select the kinds of email you would like to receive from us.
Volgistics Volunteer Alerts sends reminders, alerts, and custom messages from System Operators and
Coordinators. Use this section to opt-in and opt-out of text messaging (also known as "SMS"),
and initially set how you would like to receive messages. Your messages can be delivered as emails,
text messages, or none. You can change this at any time through VicNet. View supported phone carriers.
Message and Data Rates May Apply. For help or information on this program send "HELP" to 28344.
You can send "STOP" to 28344 at any time to opt out. For additional assistance, call 888-891-6978 or
Message frequency based on account settings.
Messages are not guaranteed to be delivered. All messages will be sent by email until you respond "YES"
to the welcome text message sent after the application form is submitted. Message preferences
can be changed in VicNet on the Account tab.
We provide an online "Volunteer Information Center" where volunteers may check their schedules, update their information, and receive messages. Please select the password you would like to use to access the online Volunteer Information Center.