Medicare Rights Center regrets that, for reasons of conflicts of interest, we cannot accept volunteers who are licensed to sell health and/or life insurance.
Volunteer Information
If possible, please upload your resume.
First Name
Last Name
Email
Address
City
State
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip Code
Phone
Birthday
How did you hear about Medicare Rights Center?
Education & Training
Please list below your educational background including high school, college, trade and any military service.
Other Vocational and/or Professional Information
Please list any other professional information (i.e., research projects, thesis subject, publications, patents, seminars, hobbies, or volunteer work) you believe is relevant to the volunteer position.
Name of Employer
Dates of Employment
Volunteer Motivations
Why do you want to volunteer with the Medicare Rights Center? What do you hope to gain from this experience?
Please describe any special training or skills you have that may help you in your volunteer position at the Medicare Rights Center.
Volunteer Role
If you are interested in the Helpline volunteer position you will be required to attend a 1 day in-person training session.
If yes, which languages?
Please describe your level of experience with computers (e.g., Proficient in Microsoft Word, comfortable using online search engines such as Google).
Approximately how many hours per week do you wish to volunteer (minimum 4 hours)?
Relevant Work and Volunteer Experience
Please describe any relevant volunteer or work experience. Whenever possible, please include organization names and dates of service.
Organization Name
Dates of Employement
Relevant experience
Organization Name
Dates of Employement
Relevant experience
References
Please provide two references (e.g., non-family members).
Name
Company/Organization
Phone Number
Email
Name
Company/Organization
Phone Number
Email
Disclaimers
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