Disaster Relief Interest Form - North Florida Nov - Dec 2018
This form is designed for those who are interested in signing up to serve in North Florida with SendMeMissions for Disaster Relief. These trips are designed for able bodies ages 16+ (Minors 15 and younger will be considered on a case by case situation and must be accompanied by at least 1 parents)

Most expenses are paid by SMM (food & water is included). *If you have food allergies, please plan on bringing your own meals & snacks.

If your spouse or family will be going as well, please fill out this interest for per person (including children/minors)

More details will be available as the trip gets closer and will be provided via emails.

When are you available to serve? (If only available on a weekend, or a few days, instead of a week, please check other and list those specific dates) *
Required
Full Name (First, Middle, Last) *
Your answer
Telephone # *
Your answer
Email Address *
Your answer
Age / Birthdate (must be 16 or older) *
Your answer
Male or Female *
Are you aware of any physical problems that may limit you? Please explain:
Your answer
Please list any medical conditions, allergies, and diet considerations.
Your answer
What is the date of your last tetanus shot? *
Your answer
Do you have health insurance? (If yes, list company & bring your card with you) *
Your answer
Special Skills and/or vocational/disaster training
Do you have access to any tools or heavy duty equipment? (Please list, if yes. You will be contacted if the items are needed for the trip.)
Your answer
Do you have a truck or SUV that can pull a trailer? *
Are you able to drive and have people ride with you? If yes, what type of vehicle do you have, how many people in addition to yourself can your vehicle hold?
Your answer
Will you be bringing an RV / Travel Trailer / Camper with you? *
If you are currently employed, have you been given permission to take time off?
What size shirt do you wear? *
Emergency Contact Name *
Your answer
Emergency Contact # *
Your answer
Emergency Contact Email Address *
Your answer
How did you hear about this trip? *
Are you part of a local church? If yes, please list church name:
Your answer
If you are part of a local church, please list your Pastor's Name & Email Address
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of SendMeMissions. Report Abuse - Terms of Service