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General Assembly

Disciples Volunteering

Registration Form
Local Mission Work General Assembly

If your family plans to work, please complete a form for each person. Complete ASAP to reserve your spot.


name

age

   

gender

 male   female

address
city

state

  

zip code

phone (office)

phone (home)

fax

e-mail

congregation

region

Health concerns we need to know about

Last Tetanus shot
date:

I plan to participate in this way
Mon. 12 to 4 p.m.
Tues. 12 to 4 p.m. 		If you select either of these times, we will provide lunch for only $5 per person.
Mon. 2 to 4 p.m.
Tues. 2 to 4 p.m. 		If you have made plans to attend an Assembly luncheon, select one of these times.
Blood drive

Day of preference, we will contact you for time slot.

We need CREW BOSSES (meaning you would be given a landscaping or painting job and a crew to help you get it done ... or, if unskilled, you would be given an unskilled task (like working in the food bank) and a crew to oversee).

If you have the skills, PLEASE consider helping out in this way. All materials will be provided. Please consider checking Crew Boss so we won't have to turn anyone away!

Are you willing to be a crew boss? yes   no

I'd prefer to be a crew boss for:
working in community garden
working in a food bank or emergency center
painting or landscaping at a school