GrapeVine: New Partner Orientation Video (2019)

GrapeVine New Partner Orientation

GrapeVine: New Partner Orientation
Orientation Video

This video is intended for healthcare professionals in Wisconsin who are interested in becoming a volunteer community partner through GrapeVine.

Please fill out the following information. Submission of this form will redirect you to the GrapeVine New Partner Orientation Video.

It will also trigger an automatic email with next steps on becoming a GrapeVine Partner, including a survey to indicate your interest. GrapeVine Staff will be in touch once this survey has been completed and submitted.

**NOTE: This orientation depicts GrapeVine programming as of Summer 2019. More recent developments and updates may not be reflected within this video. If you have any questions, please contact Chelsea Tibbetts, Program Manager, at ctibbetts@wwhf.org.**

1. First Name: *This question is required.

2. Last Name: *This question is required.

3. Your Email Address: *This question is required. This question requires a valid email address.

4. Please Re-Enter your Email Address: *This question is required. This question requires a valid email address.

5. Which Wisconsin county do you currently live in/serve?
(GrapeVine is specific to Wisconsin residents. If you do not live in Wisconsin, please provide the county which you plan to serve through GrapeVine.) *This question is required.

6. How did you hear about GrapeVine? *This question is required.

7. GrapeVine Partnership is currently available to healthcare professionals who have backgrounds in nursing or health education. Do you currently hold a degree in nursing (BSN, RN, LPN, MSN, etc.) or a certification as a health education specialist (CHES/MCHES)? *This question is required.

Please enter an 'other' value for this selection.

Comments

Upon pressing 'Submit' you will be redirected to the GrapeVine New Partner Orientation Video (12 minutes).