Presbytery of Western North Carolina

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