"We the People" Application

Fields marked with * are required.

• Name*
  
• Email*
  
• Phone*
  
• Cell Phone
  
• Street*
  
• City*
  
• State*
  Please select a state Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
• Zip*
  

• Work Day	Date	Selection
  Christmas Day	Tuesday, December 25, 2012
  MLK Day	Sunday, January 20, 2013
  Presidents Day	Monday, February 18, 2013
  Memorial Day	Monday, May 27, 2013
  Labor Day	Monday, September 2, 2013
  Columbus Day	Monday, October 14, 2013
  Veteran's Day	Monday, November 11, 2013

  
  I would like to work with:
  
  
  How did you hear about us?
  

  Synagogue
  School
  Group
  Other

• How would you classify yourself in house repair?
  Unskilled: Hmmm... I can hold a brush!
  Moderate: I can do a bit more than paint. I can do small repairs in carpentry and plumbing, etc.
  Skilled: I'm a professional. If Skilled, please describe
  
• What hours would you like to work?
  All day
  Morning
  Afternoon
• Donation
  We request a $25 donation per volunteer. This will be put toward the project's supplies, materials, and professional labor. You will receive an email with further instructions about the donation upon completion of this form.