• • Contact Information

    NOTE: Fields with and asterisk are required. Click the blue "i" buttons for more information.
• • Volunteer Name * The name of the person who is registering to work.
    
    First
    
    Last
• • Church * Your church or the church through which you can be contacted. If you are not a member of any of these churches, please enter the name of your contact to Tres Iglesias.
    ...St Cecilia'sProspect Park MethodistSt Frances Cabrini
    Your church or the church through which you can be contacted.
• • Contact Name at Church (Leave blank If not applicable) If you are not a member of one of the listed church communities, please identify the person who is your primary connection to Tres Iglesias. If not applicable, leave blank.
    
    First
    
    Last
• • Volunteer Address *
    
    Street Address
    
    Other Address (optional)
    
    City
    ...AlabamaAlaskaAlbertaArizonaArkansasBritish ColumbiaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineManitobaMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew BrunswickNew HampshireNew JerseyNew MexicoNew YorkNewfoundlandNorth CarolinaNorth DakotaNova ScotiaOhioOklahomaOntarioOregonPennsylvaniaPrince Edward IslandQuebecRhode IslandSaskatchewanSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingYukon Territory
    State/Province
    
    Zip/Postal Code
    
    Region (optional)
    ...United StatesCanadaJapanUnited KingdomAustraliaGermanyFranceSwitzerlandItalyNetherlandsAlbaniaAlgeriaAmerican SamoaAndorraAnguillaAntarticaAntigua & BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBotswanaBouvet IslandBrazilBritish Indian Ocean Terr.Brunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslColombiaComorosCongoCook IslCosta RicaCote D'IvoireCroatiaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEstoniaEthiopiaFaeroe IslandsFalkland Isl. (Malvinas)FijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern Terr.GabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernsey C.I.GuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslHondurasHong KongHungaryIcelandIndiaIndonesiaIrelandIsle of ManIsraelItalyJamaicaJapanJersey C.I.JordanKazakhstanKenyaKiribatiKorea Republic ofKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLiechtensteinLithuaniaLuxemborgMacauMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslMartiniqueMauritaniaMauritiusMexicoMicronesiaMoldova Republic ofMonacoMongoliaMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherland AntillesNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslNorthern Mariana IslNorwayOmanPakistanPalauPanamaPanama Canal ZonePapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussian FederationRwandaSaint Kitts & NevisSaint LuciaSamoaSan MarinoSao Tome & PrincipeSaudi ArabiaSenegalSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSt. HelenaSt. Pierre and MiquelonSt. Vincent & GrenadinesSurinameSvalbard & Jan Mayen IslSwazilandSwedenSwitzerlandTaiwanTajikistanTanzania United RepublicThailandTogoTokelauTongaTrinidad & TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslTuvaluU.A.E.U.S.Minor Outlying IslUgandaUkraineUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican City StateVenezuelaViet NamVirgin Isl (British)Virgin Isl (U.S.)Wallis & Futuna IslandsWestern SaharaYemen Republic ofZaireZambiaZimbabwe
    Country
• • Primary Phone Nbr * This is the number you can usually be reached at in the evenings or at weekends.
    
    The number you can usually be reached at.
• • Primary Phone Type *
    ...HomeCellWork
    Type of phone
• • Alternative Phone Nbr An alternative number if you cannot be reached at your primary number.
    
    An alternative number
• • Alternative Phone Type
    ...HomeCellWork
    Type of phone
• • Email
    
    
• • Is this the first time you've worked on a Tres Iglesias project? *
    ...NoYes
    
• • Car Pooling. Are you willing to offer rides to other volunteers?
    ...NoYes
    

• • Emergency Contact Information
• • Who should be contacted in the event of an emergency? *
    
    First
    
    Last
• • Relationship to Emergency Contact *
    ...SpouseParentPartnerFriendOther
    
• • Emergency Contact Phone Nbr * Enter the phone number (Home, Work, or Cell) at which the person can be most readily contacted during the day.
    
    Nbr at which Emergency Contact can be reached during the day.

• • Additional Information
• • I prefer to receive my work assignment information by *
    ...Letter/PhoneEmail
    Specify your preferred method of communication
• • Are you under 19 years old? * Habitat requires that all volunteers that will actually be working on the construction site to be 16 or older. 16 to 18 year olds must be accompanied by an adult. However, there are no age limits for those working on the Food Crew.
    ...NoYes
    Habitat requires work site volunteers to be 16 or older. 16 to 18 year olds must be accompanied by an adult. NOTE: Youth under 16 can work on Food Crew.
• • Additional Comments
    
    Please add any information not covered elsewhere.

• • Scheduling

    Select the role(s) you wish to volunteer for. Specify the days you are able to work separately for each role.
• • Volunteer Role *
    ...General VolunteerOn Site CoordinatorCrew Leader
    Select a volunteer role
• • Check all the days you can work in this role *
    Fri Jan 25
    Sat Jan 26
    

• • Before you submit

    If you have not entered an email address, you may want to print this page as a record of your choices. If you have entered an email address, you will receive a confirmation email (with all your choices) shortly after you click Submit.

Authentication Text*
(Enter the text in the image above into this field.)

NOTE: Do Not Alter These Fields: