Northeastern Jurisdictional Conference Volunteer Interest Form
The Northeastern Jurisdtional Conference will be held in Charleston, West Virignia on July 18-20, 2012.  The Local Arrangements Committee is looking for volunteers -- would you consider helping?  Please complete this form to indicate your interest in hearing more about this opportunity for service.
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Name *
District
Street Address
City, State, Zip
Phone Number (Home)
Phone Number (Work)
Phone Number (Cell)
Email address
Local Church
What are your interests?  Choose all that apply.
Do you have medical training (i.e. nurse, EMT worker, doctor)?  If so, please describe.
Do you have other specialized gifts, training or skills that you could share?
What else would you like to tell us?
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