#ServeJoshua INDIVIDUAL REGISTRATION
Saturday, April 25 (9am-3pm) | One form per individual, please.
If you have a friend or neighbor who needs help with a project, complete the NOMINATION FORM here: https://forms.gle/zBuZdnFDWEnteDmW6
Name
*
Email
*
This address will receive a confirmation email
Phone
*
Address
*
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#ServeJoshua Donation (optional)
Lunch ($10.00)
Supplies ($25.00)
Other
Lunch ($10.00)
Supplies ($25.00)
Other
Amount
CHILDCARE is provided for infants, toddlers, and preschoolers 5 years and under.
*
Please select all that apply.
Yes, my child(ren) will be with the Nursery Team.
No childcare needed.
FIRST NAME and AGE of each child 5 and under in need of CHILDCARE:
*
I would prefer to serve on a:
*
Please select all that apply.
Community Project Site
Food Prep
Hydration Crew
Nursery Team
Trash + Debris Removal (must have truck/trailer)
Credit/Debit Card Number
Expiration Date/CVC
Name on Card
Card Billing Address
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AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Submit
Description
Saturday, April 25 (9am-3pm)
One form per individual, please.
If you have a friend or neighbor who needs help with a project, complete the NOMINATION FORM here: https://forms.gle/zBuZdnFDWEnteDmW6
×
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