PITC Volunteer Registration

I understand I will need a smart phone in order to conduct the survey*

Yes, I understand

Required.

Mobile Phone Number*

Required.

First Name*

Required.

Last Name*

Required.

Preferred Email*

Required.

Organization (your affiliation, if any)

Are you a Current San Bernardino County Employee*

Yes

No

Required.

Where in San Bernardino County would you like to Volunteer?*

Required.

If yes, in which department do you work?