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National Service Responds to the Hurricanes: Pass Christian Skilled Volunteer Form

 

The City of Pass Christian, Miss., has reached a stage in its rebuilding effort where it needs volunteers who are skilled in the building trades. If you have special skills and would like to volunteer in the Pass and its immediate environs, please fill out the form below.

If you are interested in helping out in other areas of the Gulf Coast, please go to www.volunteer.gov to search for a volunteer opportunity.

Please answer all questions and be as specific as possible


First Name:
Last Name:
Street Address:
Street Address
(cont.)
City:

State:

Zip:

   
Phone Number:
Cell Phone:
Email Address:

Special Skills / Training / Certifications:
 
Other:
Earliest date available:
 
End of availability: (if applicable)
 
Length of time available to serve on any deployment:
 
Other:
How much advance notice is required before deployment?
 
Are you covered by health insurance?
 
Are you 18 years of age or older?
 

By submitting this form you are certifying that all of the above information is correct
and giving permission for staff to contact you regarding potential deployment activities.

 

 

OMB Control Number: 3045-0114

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