Name:
Date of Birth:
Cell Phone Number:
Email:
Street Address:
City, State, Zip Code:
Gender:
Occupation:
How did you hear about lowernine.org and our volunteer opportunities?
Have you worked with any other Gulf Coast relief and/or rebuilding organizations?(Which ones and when?)
On a scale of 1-5(1: novice, 5: skilled professional) please rate yourself in the following areas:
Carpentry:
Electrical wiring:
Plumbing:
Roofing:
Framing:
Sheetrocking:
Painting:
Tiling:
Gardening:
Installing windows and doors:
Installing kitchen cabinets and counters:
Installing bathroom fixtures:
Use of powertools:
Do you have any physical limitation, health concerns or allergies that might prevent you from participating in rebuilding projects?
Have you ever been arrested? If so, please explain.
In three sentences or less, please tell us about yourself and why you've chosen to plan and lead this trip to New Orleans:
Group Information:
Name of school or organization:
Total number of volunteers:
Number of volunteers under the age of 18:
Number and names of adult chaperones:
** Please note: chaperones must be 23 years of age or older, present throughout each work day and willing to take legal responsibility for the behavior and well being of minors. We require one chaperone per five minors.**
Date your group will ARRIVE in New Orleans:
Date your group will DEPART New Orleans:
Dates your group plans to work Mon.-Fri. 8 AM-5 PM with lowernine:
How do you plan to travel to New Orleans?
If flying, do you have ground transportation arranged?
Has housing been arranged for your group?

We will be in touch once we've reviewed your application and our project schedule. We appreciate your interest in volunteering with lowernine.org as we work to rebuild the Lower Ninth Ward of New Orleans.
Thank You!