1.First name and last name

2.Brokerage

3.Cell Phone Number

4.What area do you want to be placed in?

Abbotsford

North Delta

Surrey

South Surrey/White Rock

Langley/Aldergrove

Mission

5.Would you like to be an emergency transport driver?

Note: An emergency transport driver transports donations from a brokerage to a charity.

Yes

No

6.Will you be able to attend this year's kick-off meeting at the Board on October 28th from 10:00 a.m. to 12:30 p.m.?

Yes

No