Medical Reserve Corp Forms

MRC Orientation Form

Date:       October 24, 2007

First Name:             Last Name:   

Primary phone #:     Email:       

1. Would you feel comfortable in a management position?            Yes            No

2. Please indicate your first and second choice of team assignment by placing checking the appropriate box: 

3. Please indicate which job categories interest you.  If more than one, please mark first and second choice.

We will do our best to assign you to the team and position you request, but must, of course, consider the needs of the community. 

Thank you so much for volunteering.

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