Register as an MRC Volunteer

To become a Lorain County MRC Volunteer, please fill out the information below. You must also register on the Ohio MRC website to ensure that you are recognized by the state as an MRC volunteer and allow for enhanced liability coverage during a disaster. You are not required to provide volunteer services outside of Lorain County; however, you can choose to assist within your county, region, state, and/or nation on the Ohio MRC application.  The Ohio MRC volunteer application takes approximately 5-10 minutes to complete. 

First Name:
Last Name:
Address:
Address:
City, State Zip: ,
Telephone:
Date of Birth:
Drivers License Number:
Drivers License State:
Drivers License
Expiration Date:
Training/Skill Completion Date  

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Add another Training/Skill
Certification Cert. Number Expiration Date  

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Add another Certification
Health Department:
Category:
Sub-Category:
 
Are you willing to volunteer in the event of a disaster?
 
 
In the event of a disaster, certain sites throughout the county are designated as emergency clinics known as PODs or Points of Dispensing. These PODs will be staffed by both health district staff members and volunteers.
Do you wish to be associated with a POD location?
 
 
Email Address:
Your email address will be your login. If you do not
have an email address, check the box below.
Password:
I understand that by clicking "Yes", I hereby certify and affirm all the information I have provided is true and accurate to the best of my knowledge. I acknowledge that my information will be added to the Ohio Medical Reserve Corps volunteer registration by the Lorain County Medical Reserve Corps Coordinator if I have not already done so. I also acknowledge that Lorain County Medical Reserve Corps/Ohio Citizen Corps/Ohio Medical Reserve Corps may verify the information.