CWS Rebuild, Cedar Rapids, Iowa

This form is for group leaders and individuals who are willing to join with other groups on-site to volunteer.  Individuals who are part of a group complete the waiver form(s) and skill level sheets linked below.

CWS Liability Waiver Form
CWS Skills Assessment Sheet

Bring completed waiver forms with you to the mission trip site.  Forms must be complete before work can begin.

Pam Small,Volunteer Registrar & Coordinator, will be in contact with you with details of your housing location and project coordinator.  You can contact Pam at  psmall66@gmail.com; cell phone (812) 453-3995. 

A donation of $50 per person per week or $10 per person per day is suggested to defray housing costs.  This is payable to the host congregation on-site.

PART I  
CHURCH/ORGANIZATION INFORMATION (for informational purposes) 
   
Church Name  
Church Address 
Church City
Church State 
Church Zip Code 
UCC Conference 
CONTACT PERSON (The one completing this form) 
   
Full Name
Address Line
Address Line 2
City
State/Province
Postal Code
Phone
Evening Phone
Cell Phone
Fax
Email
Expected Group Size
   
PART II  
After completing Part 1,  select a date, then submit the form. 
 Dates Available:  April 11 through May 21, 2010 Sunday 7 p.m. Orientation - Friday
First Choice of Dates:
Second Choice of Dates:
   
Submit the form to complete processing.       
 

SECTION MENU
CONTACT INFO

Rev. Mary Schaller Blaufuss
Executive for Volunteer Ministries
Global Sharing Of Resources
Wider Church Ministries
700 Prospect Ave.
Cleveland,Ohio 44115
216-736-3214
blaufusm@ucc.org