Public Health K-12 School Support Request

Please complete all sections and discuss directly with your health office personnel. The specific needs for your school determine the scope of work; we will deploy MRC volunteers or MCDPH staff accordingly.

School Information


Scheduling Information


Days of the Week Support is Needed

               

Primary Contact for Staffing Requests


Pease NOTE: A copy of this information will be emailed to the address you specify below.

Volunteers/Staff Information


Pease check all that apply.
Specialized Skills
 
 
 
 
 
 
 
 
Basic Support
 
 
 
 
   

Needed Information