Volunteer Form - 2012 Event

RAM Oklahoma will host its second free-care event August 25 & August 26, 2012, in the Oklahoma Expo Hall at the State Fairgrounds in Oklahoma City.

Even if you volunteered for RAM in 2010, please complete this form and select what dates you can volunteer in 2012.

As the event approaches, you will receive correspondence detailing what you need to know for the event.  Volunteers should be prepared to be on-site Saturday & Sunday by about 5:30 a.m.  (If you have time restraints, please list under "Notes.")

Thank you for helping!

NOTE: As of Aug. 1, we have enough nurses, medical assistants, medical students, dental assisting students, undergraduate students and general volunteers.  But we are still seeking dental and vision professionals.  Thank you!

Name and Contact

First Name:
Last Name:
Title:
Street 1:
Street 2:
City:
State:
Zip:
Home Phone:
(include area code: 555-555-5555)
Cell Phone:
(include area code: 555-555-5555)
Email Address:
Future Events
Would you like to stay updated about future RAM events?
Yes
No
Employer Name:

License/Specialty

If you are a health professional, list what license(s) you hold and in what state you hold it.

(If state is not Oklahoma, we will provide you a simple application for free volunteer licensure in Oklahoma.)

Type of Volunteer
*Students* please include year in school (1st, 2nd, 3rd, etc.) in "Notes"
License #
State of Licensure
*Notes
Please include any extra information. *STUDENTS* please include year in school.
Languages
Can you help with translation in any of the following languages?
Spanish
Vietnamese
Chinese

Shift Selection:

Please choose the day(s) that you are able to volunteer. Please consider volunteering both days! (Work begins at 6 a.m., except for Friday which will begin set-up in the afternoon. All meals are provided.)
Day(s)
Friday, August 24 (set-up)
Saturday, August 25
Sunday, August 26

I will show up!

I agree to attend on the day(s) I specified. If I will not be able to attend, I will contact RAM Oklahoma ahead of time at either 405-410-5411 or Savage@ramok.org.

(RAM Oklahoma will contact you prior to the event with directions and other information.)

I agree