Volunteers are needed for the Medication Cleanout event on October 29, 2011 in Lubbock, TX.  Please complete this form if you would like to volunteer.  At the end of the registration process, you will be redirected to a website to choose a shift.  Available shifts are: 9:30-1:30, 1:00-5:00, and 4:30-8:30.  All volunteers must be at least 18 years of age to volunteer and due to the nature of the event, no minors may be present in the volunteer areas.  Background checks may be performed.  A mandatory 1.5 hour training session will be required.  Time, date, and location of training to be announced in the near future.  Please contact the MCO Volunteer Coordinator at 806-351-5626 for any information or changes in your volunteer status.  If you are interested in volunteering, please complete the following: 

Please enter the information indicated below.  (Note - email will be used for all routine communication between organizers and volunteers.)

We may need to reach you by phone on the day of the event.  What is the number of the cell phone that you will have with you? Please include area code.

In the event of an emergency, please provide the name and telephone number of the person who we should contact on your behalf. Ex: John Doe, 806-555-1234.

Have you participated in a Medication Cleanout event in the past?  If yes, please indicate location and date in comment box.

With which group are you affiliated?

Laptops are needed to enter data gathered about the medication that is collected.

Will you bring a laptop with wi-fi internet access capability?

Are you bilingual (English and Spanish)?

Volunteers will be required to wear the official Medication Cleanout t-shirt.  The Medication Cleanout t-shirt is short-sleeved, but you may wear your own long-sleeved shirt or sweatshirt underneath it. 

What size t-shirt do you need?

If you would like to volunteer, but have concerns about performing certain tasks (for example, cannot stand for long periods of time or need to avoid sun exposure), please explain below.

Are you a pharmacist? (Note - It is not necessary to be a pharmacist to volunteer.  Some volunteer roles need to be filled by a pharmacist, but most do not and we need many, many volunteers.)

Are you a pharmacy technician? (Note - It is not necessary to be a pharmacy technician to volunteer.  Some volunteer roles need to be filled by a pharmacy technician, but most do not and we need many, many volunteers.)

Would you be willing and able to put a small sign in your yard the week of Medication Cleanout to increase awareness of the event?