TRAINING SIGN UP SHEET

Are you an active member of a Southern Baptist Church? YES NO
Name _______________________________________________Birth Date ____________________
Availability (How much advance notice do you need?) ____________________________________

REGISTRATION
DISASTER RELIEF MINISTRY

Have you previously attended Disaster Relief Training? YES NO

Are you an active member of a Southern Baptist Church? YES NO

Name _______________________________________________Birth Date ____________________

P.O. Box No. __________Street Address ________________________________________________

City/Town __________________________________ State ________ Zip Code ______________

Home Phone (include Area Code) (____)______________Work Phone ( ___ ) ________________

Cell Phone (____)_______________________ E-mail_____________________________________

Present Occupation________________________ Previous Occupation _______________________

Do you have a CDL license? YES___ NO___ CDL Class _______CDL Endorsements ________

Physical limitations _________________________________________________________________

Spouse’s name _________________________Spouse’s Work Phone (____) ___________________

Availability (How much advance notice do you need?) ____________________________________

Do you have a current passport? YES ___ NO ___ Are you a certified chaplain? YES__ NO__

Church Name ____________________________________City______________________________

Association Name ___________________________________________________________________

Today’s date ______________ Location of Today’s Training (City) _________________________

Sign and date the Volunteer Agreement on the reverse side of this page.

Bring this form to the Registration Desk after you have completed the training today.

STOP HERE!: Registration Staff will fill in the information below this line.

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