Application Forms

There are two forms that all applicants are asked to complete and send to the Coordinator, to become members of the unit.

1. An Application, with copies of any appropriate documents (such as a nursing license, EMT certification, or CPR card). Usually it takes less than ten minutes to complete the application.
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2. A CORI form . As with most volunteer organizations that involve contact with the public, the MRC takes reasonable steps to ensure the safety of its members and the community being served by running a background check. Per the regulations established by the state of MA that were updated in May of 2012, the procedure requires us to view the member's identification (or a photocopy), such as a driver's license or passport. Please remember to INCLUDE A PHOTOCOPY OF YOUR LICENSE when you send us a CORI form, because we can't run your background check until we have the photo ID in hand!!! A legible fax (sent to 978-399-2565), or scanned copy sent in e-mail (to nburns@westfordma.gov) is also sufficient.

To properly download and view these forms, you will need the free Adobe Acrobat reader installed on your computer. Most computers have Adobe Acrobat already installed. If Adobe Acrobat is not on your computer, you can follow the download and installation instructions here.
Click here to download and install the free Adobe Acrobat reader

These documents can be given to the coordinator or mailed to the following address, as printed on the forms:
   
Ms. Nancy Burns, Coordinator    
Upper Merrimack Valley MRC    
c/o Health Department
55 Main Street   
Westford, MA 01886

In case of questions, please call 978-399-2549 or send e-mail to Nburns@WestfordMA.gov.

 

 


Upper Merrimack Valley Medical Reserve Corps, 55 Main Street, Westford, MA 01886