2014 AIHREA Health Fair Pow Wow Volunteers

Please take a moment to fill out the following information if you are interested in volunteering at the health fair at the AIHREA pow wow. This is a large event and it takes many hands to make it a great event.

* 1. First Name

* 2. Last Name

* 3. Primary Email Address

* 4. Best phone # to reach you

* 5. I am a...

* 6. If you have a specialty, please enter it here.

* 7. I am available to work the following times

* 8. I am willing to work a total of _________ 3 hour blocks.

* 9. If you have a preference for a particular screening(s), please check all that apply: