Gleanings Application Form
IMPORTANT PLEASE READ INSTRUCTIONS BELOW:

EACH PARTICIPANT MUST ALSO FILL OUT THIS QUESTIONAIRE: https://tinyurl.com/gleaningsquestions

Dates: Sunday, January 14, 2018 (arrive at Gleanings by 4-5pm) through
Tuesday, January 16, 2018 (leave Gleanings after workday around 5pm. Dinner on the road).
Place: Gleanings for the Hungry. 43029 Rd 104, Dinuba, CA 93618. 559-591-5009
Who: All ages are invited to come and help. Even kids as young as 3 can help =).
Cost: A minimum donation of $15/day a person is encouraged to cover costs.
Monday Meals: B, L, D and snacks. Tuesday Meals: B, L and snacks will be provided.
Rooms for families are like motel style rooms, with a possible shared bathroom with one other family from GrX.
There are also dorm rooms with bunks, with a public restroom.

Training Dates
Sun., December 10, 2017. 2:30-4pm @ GrX Ministry Center. 2346 Walsh Ave., Santa Clara, CA.
Sun., January 7, 2018. 2:30-4pm @ GrX Ministry Center. 2346 Walsh Ave., Santa Clara, CA.

Please read the Gleanings Handbook for a lot more information, including daily schedule, what to pack, what to expect. These things and more will also be covered during our training sessions together. Also, check out their website: www.gleanings.org.

I'm interested! What do I need to do?
1. Read the Gleanings Handbook
2. Complete GrX Gleanings Application Form (1 per family)
3. Complete GrX Gleanings Questionaire and Mandatory Gleanings Release Form (1 per individual)

Space is limited. Please submit ALL paperwork to Jenn Chang to reserve your spot for this year. Bring to KidZone at GrX or send to:
2346 Walsh Avenue
Santa Clara, CA 95051

Contact Jenn Chang for if you have any questions. 650-759-5016 or jenn.chang@grx.org.

Name of Participants (Ages) please list all family members and ages of those attending *
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Health Provider & Medical Insurance # for each participant *
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Address *
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Contact Cell Phone (s) *
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Contact Email (s) *
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