REGISTER

Complete the following form if you wish to volunteer yourself or a team of people

to come and help with relief efforts. Someone will contact you shortly to confirm.

We are only accepting volunteers between now and the end of the year. If you are

interested in volunteering in 2011, please contact Epworth Ministries.

INDIVIDUAL OR GROUP NAME:

UMC Conference:

Country:

Fax Number:

Contact Name:

Street Address:

City:

State: Zip:

Contact Email Address:

Contact Home Phone:

Contact Work Phone:

Contact Cell Phone:

Best Number to Call:

Arrival Date:

Departure Date:

Total number of volunteers on your team including yourself:

*Team members must be at least 14 years old. (Ages 14 - 16, 1 adult

per 3 youth; Ages 16 - 18, 1 adult per 5 youth, Ages 18 - 24, 1 adult per 10 students. All adults must be 25 years old!)

Registration Forms Packet for Volunteer Teams – PDF form

Have you or any of your team members had any disaster response training? Yes No

Do you have accident insurance? Yes No
If yes, please indicate policy carrier and number:

(Note - proof of accident insurance is required)

If you do not have Accident Insurance Coverage - please click on the

following and purchase: Insurance Application Form with the General Board

of Global Ministries: PDF Form

What are your team's housing needs? (Check all that apply)
Require housing
Have camping trailers
Will secure own housing
If yes, where are you staying:

Please indicate any special skills you or any of your team members will be bringing (check all that apply):

Medical Team
Construction (or closely related industry)
Roofing, Electrician, Plumbing, HVAC:

Please check your preferred work station:

New Orleans Southeast Center

Slidell Northshore Center

Comments: