AZSBC Disaster Relief Volunteer Form

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In order to serve with Arizona Southern Baptist Disaster Relief, you must:
- Complete this form and submit it.
- Complete and pass a background check (if you have not done so with us within 3 years)
- Send in a photo (headshot) for your badge
- Fees from classes cover the cost of the background check, badge, and shirt/hat

Name *

Check One: *

I am new to Disaster Relief

I am already a part of Arizona Disaster Relief and have taken Chaplaincy before.

I am already a part of Arizona Disaster Relief but have not taken Chaplaincy.

Email address *

Date of Birth *

YYYY

Current Address (Street, City, State, Zip) *

Cell Phone Number *

Gender *

Female

Male

Occupation *

Name and City of Church *

T-Shirt Size *

2XL

3XL

4XL

Medical Restrictions

Emergency Contact Information (Name, phone number) *

Do you currently have any of these? (Check any that apply)

Passport

CDL License

Ham Radio License

Maricopa County Food Handler's Card

Serve Safe Kitchen Manager Certificate

If CDL, what license is it for?

If Serve Safe Kitchen Manager Certificate, please enter expiration date

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