Presbytery of Western North Carolina

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Volunteer Survey

INDIVIDUAL VOLUNTEER SURVEY

Name:__________________________________ Church: ____________________________ 
Day phone # __________________ Night # ________________ Email: __________________ 
Complete Address: ___________________________________________________________ 
Times Available: _____________________________________________________________ 
{days of the week; or specific dates; or for how long (e.g., one week in January)} 
Type of vehicle/#number of passengers, if willing to drive to site __________________________ 
Health Insurance Co/Policy # ____________________________________________________ 
Medical problems that might limit your activities ______________________________________ 
Emergency contact: _______________________ Phone #'s: ___________________________ 
Primary physician's name and number: _____________________________________________

SUMMARY OF SKILLS

Foreman (F) - able to lay out amterials and work, oversee others 
Journeyman (J) - skilled and equipped 
Handyman (H) - some experience and equipment 
Unskilled (U) - no skill

Circle the appropriate level of each skill. Also note at bottom if you are NC licensed in a trade. 
Specify details and particulars in final column where appropriate.

F

J

H

U

Concrete - forming/pouring/finishing  

F

J

H

U

Masonry - block/brick

 

F

J

H

U

Plumbing  

F

J

H

U

Electrical  

F

J

H

U

Heating/Cooling  

F

J

H

U

Rough Carpentry - framing/repairs  

F

J

H

U

Finish Carpentry - doors/cabinets/trim  

F

J

H

U

Roofing  

F

J

H

U

Hanging drywall  

F

J

H

U

Finishing drywall  

F

J

H

U

Siding - vinyl/aluminum/wood  

F

J

H

U

Painting  

F

J

H

U

Laying carpet  

F

J

H

U

Laying linoleum  

F

J

H

U

Administrative/Office  

F

J

H

U

Counseling Casework  

F

J

H

U

Operating Equipment  

F

J

H

U

Medical Traning  

F

J

H

U

Camp Cooking  

F

J

H

U

Cooking for a crowd  

F

J

H

U

Photography  

F

J

H

U

Writing  

F

J

H

U

Child Care  

F

J

H

U

Bible study/group reflection leadership  

F

J

H

U

Music  

Please list any other gifts of personality, training, or experience that you think might be useful to a mission team (patience, ability to speak Spanish; physically strong, etc.)

If you want to be entered into the Presbytery of WNC data bank of potential disaster team participants, please return this form to:

PWNC Disaster Response Network
114 Silver Creek Rd
Morganton, NC 28655