B.C. Wildfire Response 2023

CDR Volunteer Application - Generic

Location(Required)

Please click or tap in the box to select your preferred shift. If you wish to volunteer for additional weeks/days. Please click or tap in the box to select each day you wish to volunteer for.(Required)

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I would like to request overnight accommodations

Arrival Date/Time

Arrival Time

Departure Date/Time

Departure Time

Note: If you are unable to volunteer for the full duration of the shift, please let us know in the box below.

Contact Info

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City Province | State Postal Code | Zip Country

Primary Phone #(Required)

Primary Phone Type(Required)

Secondary Phone #

Secondary Phone Type

Email(Required)

Please send me email updates about Samaritan’s Purse initiatives (you can withdraw your consent at any time)

Sex(Required)

Date of Birth(Required)

Are you volunteering with a church, organization or group? (optional)

Other Church/Organization/Group (optional)

Parent/Guardian

Volunteers must be at least 16 years of age, and youth ages 16 and 17 must be accompanied by a parent/guardian

Name(Required)

First Last

Emergency Contact Info

Name(Required)

First Last

Phone number(Required)

Relationship(Required)

Health Info

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Provincial Health Care Number

Health concerns/allergies or medications

Volunteer Info

T-Shirt size(Required)

I have read and agree to Terms of Use and Privacy Policy. For more information or if you have questions please call: 1.800.663.6500

I have read and acknowledged the Samaritan's Purse Statement of Faith.

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CDR Volunteer Application - Generic

Contact Info

Parent/Guardian

Emergency Contact Info

Health Info

Volunteer Info

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