1. AUSTIN SHMIRAH REGISTRATION FORM

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* 1. First name (as you wish to be addressed)

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* 2. Last name

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* 3. Mobile phone number (include area code)

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* 4. Home phone number (include area code)

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* 5. Other phone number (include area code)

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* 6. Primary e-mail (PLEASE DOUBLE-CHECK SPELLING)

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* 7. Alternate e-mails (PLEASE DOUBLE-CHECK SPELLING)

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* 8. Shomrim under age 18 may serve alone during funeral home office hours, or with an adult at other times. 

Are you at least 18 years old?

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* 9. What is your affiliation? Check all that apply.

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* 10. CONGREGATION--SHOMER MATCH:
Different congregations in our community follow different traditions regarding who may participate as a shomer. By honoring these differences, we honor each deceased and comfort each family in the ways that are most meaningful to them. Only congregations you choose to partner with may contact you. 

Each member congregation’s requirements for shomrim are listed below. Please check ALL AND ONLY those for which (1) you meet all stated requirements and (2) you are willing to serve.

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* 11. YOUR AVAILABILITY: Please check all blocks of time when you are GENERALLY available to serve.
NOTE: Being "generally available" does not obligate you to serve at any particular time. We ask this to help the coordinator call the people most likely to to be able to fill a particular shift.

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* 12. Please list days when you usually CANNOT serve during the times you checked above.

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* 13. Approximately how often are you willing to serve?

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* 14. Please mark all that describe you.

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* 15. Additional comments

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* 16. TO COMPLETE YOUR SURVEY, CLICK "DONE" BELOW. THANK YOU!

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