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?*
-
Adelanto
Apple Valley
Barstow
Bloomington
Colton
Fontana
Muscoy
Ontario
Redlands
Rialto
San Bernardino
Twentynine Palms
Unincorporated Mountain Communities
Upland
Victorville
Yucaipa
Yucca Valley
Required.
If yes, in which department do you work?
-
Aging & Adult Services
Arrowhead Regional Medical Center
Behavioral Health
Child Support Services
Children & Family Services
Community Revitalization
Human Services Administration – Support Divisions
Preschool Services Department
Probation Department
Public Health
Public Works
Registrar of Voters
Sheriff’s Department
Transitional Assistance Department
Workforce Development Department
Other Department Not Listed