Registration (Professionals Vision)

Free Vision Clinic

October 25 & 27, 2024

Thank you for volunteering!

Our free vision clinic will be held at the North Cascade Seventh-day Adventist Church on October 25 and 27. Volunteers are needed in several different departments.

This form is for HEALTH PROFESSIONALS. If you would like to serve as a general volunteer, please visit this link to fill out a different registration form.

First name

Preferred Name (if different from your legal name)

Last name

E-mail

Phone

Address

In which positions could you volunteer?

Is there anything we should know about your department selections?

Are there any languages that you could provide translation for during the clinic?

When are you available to volunteer?

Friday, October 25 (Clinic)

Sunday, October 27 (Clinic)

Sunday evening, October 27 (Teardown)

Is there anything we should know about your availability to volunteer on the dates you selected?

Have you volunteered at a free vision clinic at this location before?

Yes

No

Please provide an Emergency Contact:

Emergency Contact Phone Number