Human Relations Commission: 9th Annual Indiana Black Barbershop Health Initiative Volunteer Questionnaire

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The Evansville Commission on the Social Status of African-American Males along with local community organizations, is pleased to participate in the 2019 Indiana Black Barbershop Health  Initiative sponsored by the Indiana Commission on the Social Status of Black Males This is the 9th year for the event in which free blood pressure, glucose and body mass screenings will be available at seven local barbershops.

The Indiana Black Barbershop Health Initiative is a signature program of the Evansville Commission on the Social Status of African American Males (ECSSAAM). Since 2011, a variety of dedicated community organizations and individuals has joined in to make this community effort a success.  The Evansville-Vanderburgh County Human Relations Commission provides administrative support to the ECSSAAM.

The Evansville Initiative will take place on Saturday, April 13, 2019.  We ask that your organization participate by identifying individuals to volunteer at the barbershops.

For additional information regarding the Indiana Black Barbershop Health Initiative, please send email to hrc@evansville.in.gov or call 812-436-4927.

* Denotes a required field

Please complete the volunteer questionnaire by March 22, 2019. For additional information regarding the Indiana Black Barbershop Health Initiative, please email to hrc@evansville.in.gov

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Please provide your phone number with area code*
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Please indicate your preferred T-shirt size (M-5X*
Are you available to volunteer on Wednesday, April 10, 2019?*
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Which volunteer training session will you attend?*
 
In what capacity would you like to volunteer?*
If volunteering as Medical Volunteer, please indicate if you are a Physician, Nurse Practitioner, RN or LPN.