HAITI REBUILDING TEAM REGISTRATION
Exit this survey

Once a total assessment of the needs of the churches and national compound have been completed and we are assured of safety, food, water, and working materials we will begin to schedule teams for various projects.

Every traveler should check with the CDC and your private physician regarding recommendations for immunizations, etc. before traveling to Haiti.

A valid passport is required for travel.

1. Contact Information:

Contact Information: Name:
Address:
Address 2:
City/Town:
State:
ZIP/Postal Code:
Country:
Email Address:
Phone Number:

2. Cell Phone Number:

Cell Phone Number:

3. Work Phone Number:

Work Phone Number:

4. Age:

Age:

5. Gender:

Gender: Male

Female

6. Please provide the following information about your home church:

Please provide the following information about your home church: Pastor's Name:
Church:
Address:
Address 2:
City/Town:
State:
ZIP/Postal Code:
Country:
Email Address:
Pastor's/Church Phone Number:

7. Please tell us what special job skills (carpenter, mason, plumber, electrician, etc.)you can provide:

Please tell us what special job skills (carpenter, mason, plumber, electrician, etc.)you can provide:

8. When are you available to travel and how many days can you stay?

When are you available to travel and how many days can you stay?

9. I would like to be a part of:

I would like to be a part of: A Local Church Team

A District Team

Any Team

Other (please specify)

HAITI REBUILDING TEAM REGISTRATIONExit this survey