Low Income Home Repairs And Weatherization by PWC

Make a Donation | Volunteer | Store

Event

Group Leader

Primary Volunteer:

First Name:

Last Name:

Street Address:

Street Address 2:

City: State: Zip:

Contact Information:

Email:

Cell Phone:

Home Phone:

Work Phone:

Emergency Contact Name:

Emergency Contact Phone Number:

Employer:

Shirt Size: SmallMediumLargeX LargeXX LargeXXX Large

I am signing up as:

Individual Volunteer
A crew leader
Clerical help
Lunch, cookout or party help (depending on event)
Registrar for event day
Photographer with equipment
Other

What are you interested in?

Events OnlyOngoing BasisBoth

When can you volunteer?

WeekdayWeekendsBoth

Please list your skills level on a scale of 1-4:

Carpentry
Concrete
Tree Trimming
Data Entry
Drywall

Electrical
Plumbing
Photography
Gutter Cleaning
Gutter Repair

Friends & Family Section:

Family Member 1 :	Under 18?
First Name:
Last Name:
Street Address:
Street Address 2:
City: State: Zip:

Relationship to you:
T Shirt Size:
Phone:

Would you like to add an additional family member?

Release Waivers

By volunteering, I allow PWC to use my image/photograph for agency promotional purposes.

I understand that volunteers who submit this form are covered up to $1,500 in medical insurance related to their specific volunteer duties.

I understand that PWC takes the privacy of our clients very seriously. We request that volunteers never breach a client’s privacy or the confidentiality of a client’s record.

By submitting this form, I do hereby release and hold harmless People Working Cooperatively, Inc. their funders, supporters, officers, agents and employees and the homeowner for whom I am doing home repairs for any major injury which I may suffer or incur as the result of my volunteering.