Shiftboard: DOC NYC Shiftboard Registration

Registration: DOC NYC Shiftboard

Welcome! Thank you for your interest in joining our team

* required field

* First Name

* Last Name

* Address

* City

* State/Province

* Zip/Postal Code

* Email

* Primary/Home Phone

Other/Work Phone

Mobile/Cell Phone

* When are you available?

Weekdays

Weekends

Both

Release from Liability Agreement
Refer to: Release Form

Yes

Copyright Agreement
Refer to: Copyright Form

Yes

* Emergency Contact Name

* Emergency Contact Phone Number

Emergency Notes/Relationship, Instructions, etc,

First Choice Interest

Second Choice Interest

Third Choice Interest

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Thank you for your interest!

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