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The Black 6 Project Hurricane Dorian Volunteer Application
Volunteer Form for The Black 6 Project's Hurricane Dorian's Disaster Relief Team
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* Indicates required question
Email
*
Your email
First Name
*
Your answer
Last Name
*
Your answer
Phone Number
*
Your answer
Date of Birth
MM
/
DD
/
YYYY
Address 1
*
Your answer
City
*
Your answer
State
*
Your answer
Zip Code
*
Your answer
Valid Driver's License
Yes
No
Clear selection
Specialized Training
General Contractor (Construction)
Military Veteran
First Responder (EMS, Firefigher, Law Enforcement)
Other:
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Nearest Airport
Your answer
Previous Experience: Please list or explain any previous experience relevant to disaster relief or humanitarian aid
Your answer
Current Employment
Your answer
If not able to deploy, please list dates available to help out around New York City/Long Island area
Your answer
Are you able to deploy February 17-24th, 2020?
Yes
No
I can but have to leave earlier or arrive later.
Send me a copy of my responses.
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