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University Christian Church Volunteer Application
Trip Date 3/12/23 - 3/17/23
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On-Campus Volunteer Application
Medical Care Authorization & Liability Release
First Name
*
Your answer
Last Name
*
Your answer
Address
*
Your answer
City
*
Your answer
State
*
Choose
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip
*
Your answer
Preferred Phone Number
*
Your answer
What is your preferred phone type?
Choose
Home Phone
Cell Phone
Business Phone
Email
Your answer
Would you like to receive snail mail from Cookson Hills?
If you are already on the mailing list, please update your preference.
Yes, please!
No, thanks
Clear selection
Would you like to receive email from Cookson Hills?
Or, if you are already on the mailing list, please update your preference.
Yes, please!
No, thanks
Clear selection
Date of Birth
*
MM
/
DD
/
YYYY
Have you previously volunteered at Cookson Hills?
*
Yes
No
Do you already receive Cookson Hills communications?
*
Yes
No
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