COVID-19 Haitian Volunteer Registration Form 2.0
On Saturday, August 8, 2020 from 10am to 6pm inside the parishall of St Bartholomew church, we will be helping our compatriots who need assistance during this pandemic crisis.

Thank you for joining the Haitian-American Campaign for Reemployment Assistance.  We value your time, skills and commitment.  HACRA is a Haitian initiative to assist our compatriots, the most vulnerable ones, during this pandemic crisis.  Let's get it done!
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Email *
First and Last name *
Phone Number *
Technology equipment assessment *
State where you live *
City where you live *
Gender *
Required
Age
Language(s) spoken at home? *
Current Occupation *
Required
Emergency Contact Details (Name)
Emergency contact Details (Phone Number)
Availability for mandatory volunteer training (1 day) on Zoom. *
Required
Volunteer Position Applying For (you can select more than one) *
Required
Availability on Saturday, August 8th *
Required
Availability on Friday, August 7th, 4pm-8pm, to assist with set up. *
The success of this campaign depends on our commitment to serve the most vulnerable ones.  Please refer 3 individuals (name, phone or/and email address) who can join the campaign.
Why do you want to serve as a volunteer? How do you hope to benefit from this?
Do you want to continue to get engaged after August 8th? *
A copy of your responses will be emailed to the address you provided.
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