PC(USA) - Presbyterian Disaster Assistance


	Team Registration

	Thank you for using the PDA online volunteer work team registration form. You should receive a call from the PDA Call Center within one week of your online registration to confirm your interest and to obtain additional information. This online form was created for your convenience. Please contact the PDA Call Center directly for questions and/or additional information at 866-732-6121. Again, thank you for your interest. * indicates required information


	About you

	First Name: *
	Middle Name:
	Last Name: *

	Address: *


	City: *

	State: *

	Postal Code: *

	Primary Phone: *
	Cell Phone:
	FAX:

	Email Address: *

	About your church

	Sponsoring Church:
	Your Position:

	If you are associated with a PC(USA) church, please select your congregation by performing a church zip code search. You may search on partial zip codes of at least three digits.

	Your PC(USA) church zip code:

	About your team

	How did you find out about this volunteer opportunity?


	Where would you like to help?


	Have you planned a work trip before? *
	Yes No

	Dates that your team is available and plans to arrive/depart

	Start Date: *
	End Date:
	How long can your team work during the availability period? *


	Number of Adults: *
	Number of Youth: *

	Type of work you would like to do

			Basic clean-up
			Bricklaying
			Carpentry
			Drywall
			Electrical
			Flooring
			General Contractor
			Masonry
			Painting
			Plumbing
			Roofing
			Welding
			Other
	A survey of team member’s skills will need to be completed and returned to the Presbyterian Volunteer Village or the hosting site a month prior to arrival to ensure the best use of skills.

	Some sites may require that your team bring tools or supplies.

	Can your team bring tools to do the work that you're volunteering for? *
			Yes
			No

	Can your team bring its own rebuilding supplies? *
			Yes
			No

	What else do you want us to know about your team?


	This form will be forwarded to the Mission Service Team Coordinator who will be in contact with you.