Communication in Times of Disaster

A Webblog of the Texas-Louisiana Gulf Coast Synod, ELCA

Lay Person Volunteer Form

Disaster Response

Your Name(required)
Email(valid email required)
Address
City, State & Zip Code
Daytime Phone
Secondary Phone
Name of Group or Congregation
Volunteer as:
Individual Family
Group/Congregation
City & State of Congregation
Size of Group (Adult + 18)
Size of Group (Youth 14-17)
Date of Availability - From
Date of Availability - To
Are you willing to travel?
yes no
How many miles?
In which of the following tasks are you or your group ... skilled?
Answer Phones office Support Networking Listening Media Transportation Donated Goods Basic Cleanup Carpentry Drywall Flooring Roofing Electrical General Contractor Masonry Painting Welding Other
... somewhat skilled?
Answer Phones office Support Networking Listening Media Transportation Donated Goods Basic Cleanup Carpentry Drywall Flooring Roofing Electrical General Contractor Masonry Painting Welding Other
...unskilled but willing to learn?
Answer Phones office Support Networking Listening Media Transportation Donated Goods Basic Cleanup Carpentry Drywall Flooring Roofing Electrical General Contractor Masonry Painting Welding Other
Languages spoken (other than English)
Do you or members of your group have any special certification (EMT, MD, CDL, Licensed Electrician, Clinical Social Worker)?
yes no
If so, please explain:
Other information that would be helpful:

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