Volunteer Form

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Volunteer Information

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Other Resources

• Episcopal Diocese of Missouri
• Habitat for Humanity - St. Louis
• National Habitat for Humanity

Name

First

Last

Address

Street Number

City

State

Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Zip Code

Phone

Primary Number

Home Work Mobile

Secondary Number (optional)

Home Work Mobile

Email

Email Address

Affiliation

Church/parish (if any)

Age

Select one

16-17

18-30

31-40

41-60

61 +

Specific Volunteer Dates

Please select the specific dates you are volunteering for:

Saturday, June 16

Saturday, June 30

Saturday, September 8

Saturday, September 29

General Availability

For future reference, please check days when you are generally available:

Weekdays Saturdays

Please verify the following

I understand that I will be required to fill out a waiver prior to being on the worksite.

I understand that I must be 16 or older to volunteer.

I understand I must have parental/guardian signature for my waiver if I am age 16 or 17.

Any additional information or questions

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