LSM/NJ - Lutheran Disaster Response Group Volunteer Registration Form
Lutheran Social Ministries of New Jersey, in partnership with Lutheran Disaster Response, is committed to the preparation and response to any natural or man-made disaster.  In the wake of Superstorm Sandy your help will be vital to the recovery process.  If your group is willing to volunteer please fill out the form below.  Once received we will contact you to discuss volunteer opportunities.  Any questions or comments may be directed to Amy Pennenga, Disaster Recovery Coordinator at apennenga@lsmnj.org.  Thank you for your interest!
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Group Information
What is your group's name? *
Group's mailing address? *
Group's city? *
Group's state? *
Group's ZIP Code? *
Group's phone number?
Group's email address?
Primary Contact Information
Please provide the name of the primary contact. *
Is the primary contact information the same as above? *
Required
Please provide the preferred phone number for the primary contact.
Please provide the preferred email address for the primary contact.
Primary contact mailing address?
Primary contact city?
Primary contact state?
Primary contact ZIP Code?
Trip and Logistics Information
Please provide the number of volunteers that will be travelling? *
Please specify separately the number of adults and youth as well as age range (Ex: 10-Adults, 10-Youth ages 13 - 17).
Group Availability *
Please provide the dates / days of the week the group is available to volunteer.  Please be as specific as possible.
Please provide some general information regarding the type of work the group is interested in doing. Also if members have skill, experience or training in a particular field. *
How will the group plan to arrive in New Jersey? *
If Other, please indicate below.
Do you have transportation while visiting New Jersey?
Clear selection
What are your housing arrangements while visiting NewJersey?
Clear selection
What are your arangements for meals while visiting New Jersey?
Clear selection
Are there any additional details or information you would like to provide that may assist in planning your volunteer visit to New Jersey?
Ex: Special accomodations, etc.
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