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Disciples Volunteering
Habitat for Humanity build

Join us in Galveston, Texas, November 7 to 22, 2009.
To participate, return this form as soon as possible.

The cost of this trip (excluding airfare/travel expenses) is $175 per person per week. Up to 40 people can participate each week. For commuters, the fee is $25 per person per day (for those living in or near the Galveston area). Registration fees and release of liability forms will be due in the Disciples Volunteering office October 5, 2009.

Questions?
Contact Disciples Volunteering staff at (888) 346-2631 ext. 2642.

General information

Name
(individual)

Name of group

Contact
person
(if different than above)

Address

City

State

  Postal code

Phone
(office)

Phone
(home)

Cell

E-mail

Select work week

I/Group will come the week of November 7, Galveston, Texas

I/Group will come the week of November 14, Galveston, Texas

Approximate number in group:


Final information

We must receive payment by the trip deadline (posted above with trip date). Earlier is better. Make checks payable to Disciples Home Missions. Send payment to: Disciples Volunteering; P.O. Box 1986; Indianapolis, Ind. 46206.
I have read and understand the above statement.