Volunteer Form

*** NOTE *** As of Thursday, July 1, RAM Oklahoma is NOT accepting any new "General" volunteers or  non-dental "student" volunteers.
In fact, we are ONLY accepting the following NEW volunteers:  Dentists, dental hygienists, dental assistants, optometrists, ophthalmologists, MDs and PAs.
Thank you, we have had a great out-pouring of support!

Please complete our Volunteer Form if you are interested in becoming a Remote Area Medical Oklahoma, Inc. volunteer.

Volunteers need to be on-site Friday - Sunday by about 5:30 a.m.  and should enter along May Avenue, just south of NW 10th Street.  Look for "Gates 3 & 4."

Name and Contact

Please enter your name, phone number, preferred e-mail address, home address, and the medical organization you work for (if applicable).

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:
Employer Name:

License/Specialty

If you are a health professional, please state 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 going to volunteer. (Work begins at 6 a.m., except for Thursday which will begin set-up in the afternoon)
Day(s)
Thursday, July 8 (set-up)
Friday, July 9
Saturday, July 10
Sunday, July 11

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 specific directions to the site and other information.)

I agree