Medical Reserve Corp Forms

Orientation Form    HIPAA     Liability Form    MRC Application

Greater Prince William Medical Reserve Corps
Voluntary Action Center
9248 Center Street
Manassas
, VA 20110

Dear Prospective Volunteer,

Thank you for considering joining the GPWMRC.  Attached you will find some information
on what the MRC is about, along with forms to complete and a training schedule.  Please
read everything carefully, and if you have any questions, feel free to email or call me
for explanations.

The GPWMRC needs YOU.  Whether you are a healthcare professional or a “regular”
citizen, you can help.  In addition to physicians, nurses, veterinarians, dentists,
pharmacists, mental health professionals, respiratory therapists, physical therapists,
or any other medical professional you may think of, if you speak a foreign language, have a
skill for organizing people, want to help direct traffic or citizens in need, watch children
while their parents are being assisted, or transport volunteers or victims, we need you
Please complete the application form and fax or mail it to me as soon as you can.  Training
is in progress; you can join at any time.

If you want to help but are unable to join the MRC at this time, please consider a tax
deductible monetary gift.  Our sponsor, the Voluntary Action Center of Greater Prince
William, is a 501 (c) 3 charitable organization and can accept funds in support of
MRC volunteers.  Donations should be made payable to “VAC” and marked “MRC Support”
on the memo line.  Your donation would be used solely to provide MRC volunteers with
text books, uniforms, flashlights, back packs, and other needed items.  We operate only
through grants and donations. 

Thank you very much for considering joining and/or donating to the Greater Prince
William MRC.  When you need us, we will be there.

Very sincerely yours

Susan R. Leferson
Coordinator, GPWMRC

sleferson@volunteerprincewilliam.org
(703) 369-5292 x 204

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For more information,  call Sue Leferson, Medical Reserve Corps,
(703) 369-5292, Ext 204
sleferson@volunteerprincewilliam.org