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Community Public Health and Scientific Faculty (CPHSF) Application

  1. I have been approved as a BVRC volunteer*

    If you are not a BVRC volunteer, please see the below steps on how to become one:

    • Go to maresponds.org and Click on "add organization". Pick "Region 4A" as the "region" and "Burlington Volunteer Reserve Corps" as the "unit affiliation".
    • Come to the Board of Health office to have your picture taken for an ID badge and to complete a CORI form.

    For hours or assistance, call the Board of Health at 781-270-1955.

  2. What area is your presentation going to cover? Check all that apply.*
  3. Do you represent an organization?*
  4. What is the length of your presentation:*
  5. Please upload/attach the following:
  6. PROFESSIONAL/ETHICAL CONDUCT*
  7. This is an electronic signature to submit your application, there is no need to print or download this form for a physical signature.

  8. If you have any questions or concerns, please contact the Board of Health at 781-270-1955 or email boh@burlington.org.
  9. Leave This Blank:

  10. This field is not part of the form submission.