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Catherine Mahaffey East Whatcom Wellness Fair Registration
Katie Rose
2025-01-30T16:24:05-08:00
Wellness Fair Registration
RSVP for the Wellness Fair
Provider Registration
Volunteer for the Fair
2025 Catherine Mahaffey East Whatcom Registration
Step
1
of
4
25%
Tell Us About You
Name
(Required)
First
Last
Email Address
Phone Number
Phone number is required If you are interested in scheduling an appointment or would like to request Door-to-Door Transportation Assistance
ZIP Code
Enter your ZIP code
Are you interested in volunteering at the health fair?
Yes
No
Who Will Be Attending?
How many people will be attending the health fair in your party?
Please include yourself in the total.
Are there children in your group?
Yes
No
Are there any children up to the age of 17 in your group?
How many children will be attending?
What Services Are You Interested In?
Insurance is not required to receive medical services at the health fair. Services are not guaranteed and depend upon provider availability and event capacity.
Are you interested in scheduling an appointment for services at the health fair?
Yes
No
Currently available services include: medical appointments, dental care, vision services, and Drivers Licensing Services.
Would you like to make an appointment for any of these services? (Select all that apply)
Medical
Dental Care
Vision Exams
Drivers Licensing
Are you interested in scheduling door-to-door transportation services?
Yes
Not at this time.
Please note that by selecting "yes" you are also giving permission for the East Whatcom Regional Resource Center permission to share your personal information with the Whatcom Transit Authority. We will only share information directly related to scheduling an appointment and will not share details about services you are scheduling.
Pick-Up Address
Street Address
Address Line 2
City
ZIP / Postal Code
Phone Number
How many people are you requesting a ride for from this address?
Do you use one of the following mobility devices?
I do not use a mobility device.
Wheelchair
Walker
Cane
Scooter
Other
Help Us Plan Future Events
What other services would you like to see offered at the Catherine Mahaffey Health Fair?
Foot Care
Dental
Sexual Health
Hearing Tests
Memory Checks
Physical Therapy
Nutritional
Chiropractic
Please indicate what other services you would like to see offered at the fair. If these services become available for the 2025 event, East Whatcom Regional Resource Staff will contact you via email.
Other (please specify):
2025 Catherine Mahaffey East Whatcom Wellness Fair Provider & Vendor Registration
Step
1
of
3
33%
Tell Us About You
Name of Organization or Business
Name
(Required)
First
Last
Email Address
(Required)
Enter Email
Confirm Email
Email Permission
(Required)
Contact me only about the health fair.
Contact me about all events and programs happening at East Whatcom Regional Resource Center.
Phone Number
Organization Website
Logo File
Accepted file types: jpg, png, , Max. file size: 10 MB.
Please share an image file of your logo to be included on our website.
What You'll Provide
Services
Services
Please describe the services you plan to provide at the health fair.
Resources
Resources
Please describe the resources you plan to provide at the health fair.
Activities
Activities
Other/Not Sure
Other/Not Sure
Please describe the activities you plan to provide at the health fair.
Team and Booth Setup
How many staff members from your organization will be attending?
(Required)
Will your organization fit at a standard tabling setup (one table and two chairs)??
Yes
No
Do you require an inside space?
Yes
No, but it is preferable
No
Do you need to reserve any of the following equipment?
Table
Chairs
I am able to provide my own equipment
Please note: we ask all providers who are able to provide their own equipment to please do so. While EWRCC is able to provide some tables and chairs, supplies are limited.
Will you need access to an electrical outlet?
Yes
No
Will you need access to the EWRRC WiFi network?
Yes
No
Please note: the EWRRC network does not meet current HIPAA compliance standards. If using EWRRC WiFi, providers must use their own VPN or other security measures.
Please describe any additional space or special setup needs:
Volunteer for the 2025 Catherine Mahaffey East Whatcom Wellness Fair.
"
*
" indicates required fields
Step
1
of
4
25%
Volunteer Interest
This field is hidden when viewing the form
Embed Page URL
Volunteer Interest
Meal Preparation or Gardening - Maple Alley Inn
Support for Seniors - Chore Program
Financial Wellness - Mentor EcSA Program
East Whatcom Regional Resource Center (EWRRC)
Early Learning & Family Services (ELAFS) / Preschool
Fundraising or Other Events
Board / Committee Member
Interpretation / Translation
Other/Not Listed
Other Volunteer Interest
Maple Alley Inn Volunteer Roles
Meal Preparation
Gardening
Other
Early Learning & Family Services / Preschool Roles
Parents as Subs
Classroom Aide
Other
Currently volunteer opportunities in the Early Learning Department at Opportunity Council are only available by referral from an Opportunity Council Staff member.
Referring Opportunity Council ELAFS Staff Contact:
East Whatcom Regional Resource Center (EWRRC) Volunteer Roles
Catherine Mahaffey Wellness Fair Volunteer
Resource Center Support
Other
Catherine Mahaffey East Whatcom Wellness Fair Volunteer Roles
Parking Lot Attendant
Guest Guide
Survey Table
Language Interpretation
Health Service Helper
Event Setup
Event Teardown
Floater
Intake Helper
Exit Table
Have you volunteered at past Wellness Fairs?
Yes
No
Contact Information
Name
*
First
Last
Phone
*
Email
*
The Hotsheet is the Volunteer Center of Whatcom County's periodic newsletter sharing current volunteer opportunities in Whatcom County.
Please let me know about volunteer opportunities available with Opportunity Council Partners
The Hotsheet is the Volunteer Center of Whatcom County's periodic newsletter sharing current volunteer opportunities in Whatcom County.
Address
*
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Are you over 18?
Yes
No
Is this for court ordered community service?
Yes
No
Recommended by:
If you were recommended by an Opportunity Council team member, please let us know. If not, please leave blank.
Availability
During which hours are you available for volunteer assignments? Most volunteer positions are available during regular office hours Monday - Friday 8am to 5pm (please check all that apply)
Monday
Morning
Afternoon
Tuesday
Morning
Afternoon
Wednesday
Morning
Afternoon
Thursday
Morning
Afternoon
Friday
Morning
Afternoon
Other availability:
Volunteer Experience and Relevant Skills
Summarize special skills and qualifications you have acquired from employment, previous volunteer work, education, or through other activities.
Emergency Contact
The person we should contact in case of emergency.
Name
First
Last
Relation to Volunteer
Phone
Optional Questions (please check all that apply)
I have served in the Armed Forces
I am a current or former Head Start parent
I am a current or former Opportunity Council client
Application Agreement
By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted as a volunteer, any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate dismissal.
I agree to the terms outlined above
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