Non-Medical Vaccine Volunteer Form First Name *Last Name *Phone *Email *Current Occupation / Profession *No Occupation No Current OccupationRole Interest *GreeterPatient Flow CoordinatorPatient Flow RepresentativeMedical ScreenerObservationLogistics/RunnersSecond Dose Appointment SchedulerIf you are interested in the Medical Screener Role, it also requires an HCS registration. Info on signing upInformation for Ulster County IDAddress *Address Line 1Address Line 2CityStateZipDate of Birth *Gender *MaleFemaleOtherLast 4 Digits Social Security # *Picture of the Front and Back of Your Driver’s License * Drop your files here or click here to upload You can upload up to 2 files. Accepted file types are jpg, jpeg and png.Head shot picture of you (from the neck up) for your ID Badge * Drop your file here or click here to upload Accepted file types are jpg, jpeg, and pngWebsiteSubmit