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Morris County Medical Reserve Corps

Morris County MRC Non-Medical Volunteer Application

Personal Information

Date of Birth

Date Picker

Enter at least one phone number:

Do you currently serve in the National Disaster Medical System?

Do you possess a valid driver's license?

Are you at least 18 years old?

Are you a U.S. citizen?

Employment Information

Emergency Contact

Enter at least one phone number for your emergency contact:

Additional Information


Do you have any of the following skills?

Training/Continuing Education

Have you completed any training or continuing education programs in the following areas?

Expectation of NJ Medical Reserve Corps Professional Health Volunteers

As a volunteer with the New Jersey Medical Reserve Corps, I will be called upon to assist in the event of a public health emergency. I agree to attend an education program to explain my role in disaster preparedness; I will be assigned duties based on my level of training and experience. I understand that submitting this application does not guarantee acceptance into the NJ Medical Reserve Corps. The information contained in this application is, to my knowledge, truthful. I agree to serve my fellow citizens to the best of my professional ability.

I agree to the above statement. Failure to agree to the above statement invalidates application.