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Easy two-step process to apply for MMRC

MMRC has combined the membership application with the ESAR-VHP registration, making it one simple process for volunteers:

Emergencies wait for no one - be registered to serve when you are needed the most.

Step 1: Complete the MMRC Application below
Step 2: Complete Alabama Responds (ESAR-VHP) registration

First name*
Middle initial*
Last name*
Date of birth* (MM/DD/YYYY)
Home address*
Zip code*
Home phone*
Cell phone*
Primary e-mail address*
  * required
How did you hear about the MMRC?
Preferred mode of communication and notifications Home Phone   Cell Phone  Text Message   Email Message
I have read and understand the MMRC Policies and MMRC Agreements.
I give consent for a background investigation as explained in the MRC Agreements.
Checking this box serves as my online signature.
Today's date* (MM/DD/YYYY)

Mobile County Health Department MCEMA ADPH USPHS HHS FEMA Medical Reserve Corps