Benicia Volunteer Registration Page

Please fill in the fields below. All fields marked with a * are mandatory.

First Name *
Last Name *
Company
Address*
City*
Zip*
Phone Number*
E-mail *

Please select one or more items of interest below.

I'd like to learn more about an upcoming B.E.R.T. Class. Please have someone contact me.
I'd like to learn more about the Neighborhood Watch Program (NWP). Please have someone contact me.
I'm interested in the Volunteers in Police Service (VIPS). Please have someone contact me.
I'm interested in the Volunteers FireDepartment (VFD). Please have someone contact me.
I am a Medical Professional. I'd like to learn more about the Medical Reserve Corps (MRC). Please have someone contact me.
I'd like to learn more about the Benicia Amateur Radio Club (BARC) and the Solano Auxiliary Communication Service (ACS).  
                   
 You may enter any message or additional comments below:

Thank you for your interest in Volunteering.

Webmaster@BeniciaCCC.org