Group Registration Form
This form is for group leaders and individuals who are willing to join with other groups on-site. Individuals who are part of a group do not need to complete this form.
Completing this form does not guarantee placement. The requests will be placed in the schedule in the order this completed application is received. Groups are requested to arrive on Sunday and depart on the following Saturday. You will be contacted to confirm the dates you have requested. If your requested date is full, you will be asked about the possibility of your service on another date.
Volunteers must be at least 16 years of age. Volunteers under the age of 19 must return the parental release form. All volunteers in each group must return liability release forms. These forms are due to the Disaster Recovery Coordinator, Little Farms UCC, 135 Suave Road, River Edge, LA 70123 at least 3 weeks before your confirmed date of arrival. Forms are available here.
A donation of $50 per person per week or $10 per day if less than a week, is suggested to defray housing costs. This is payable on-site.
Any questions? Please contact Volunteer Coordinator at email@example.com or by phone 504-258-7306 or UCC South Central Conference Minister for Disaster Response and Recovery, Rev. Alan Coe at firstname.lastname@example.org.
|Church/Organization Information (for informational purposes)|
|Church Zip Code|
|Contact Person (the one completing this form)|
|Address Line 1|
|Address Line 2|
|First Choice for Arrival/Departure Dates|
|Second Choice for Arrival/Departure Dates|
|Place the estimated number of persons in each age and gender category.|
|Number of people in the group ages 16-19|
|Number of people in the group ages 20-35|
|Number of people in the group ages 36-49|
|Number of people in the group ages 50-65|
|Number of people in the group age over 65|
|Number of women in the group|
|Number of men in the group|
|Indicate the number of volunteers in your group with skill in each trade category listed below.|
|Concrete (forming/ pouring/finishing)|
|Masonry ( block/brick)|
|Rough Carpentry (framing/repairs)|
|Finish Carpentry (doors/cabinets/trim)|
|Power Tools, Heavy Equip|
|Trade Licenses held|
|State/s of licnesure|
|Specify building material donations, if any|
|Specify amount of cash contributions, if any|
How did you learn about this disaster recovery program?