| Volunteer Application for Gibson County Health Department The Gibson County Health Department is currently recruiting volunteers to assist in a Public Health Emergency. In the event of an emergency or disaster where a large number of people in Gibson County require medications, the Health Department would need assistance. We need medically trained volunteers to assist with paperwork, medical screening/evaluation, medication dispensing/vaccinators and other various jobs. We also need non-medical volunteers to assist with communication, translation, supply tracking, paperwork and client assistance. If you are interested please fill out the form below and return to Troy Sanders, Local Public Health Coordinator at the Gibson County Health Department, fax # 386-8027. For questions or comments please contact Troy at 385-3831. Name____________________________________________ Last, First Workplace_________________________________ Title_____________________________________________ Address__________________________________________ Street City, State, Zip Home Phone______________ Work Phone______________ Cell Phone_______________ E-mail_________________________________________ Special training, experience and area of interest: __________________________________________________ __________________________________________________ ____________________________________________________________________________________________________ Signature__________________________________ Date________________________ |