Hosanna Industries' Individual Volunteer Form

Name
First Last
Street Address & City*
Zip Code*
State*
Phone*
Email*

We won't spam you, this is just in case we need to contact you about volunteering. You can sign up for our emails at the bottom of our website hosannaindustries.org, if you'd like to receive them.
First time Hosanna Industries' volunteer?*
- Yes
- No
Group*
If you are coming with a group from your church or business, please select the organization. If not, please select "NONE" (or "Hosanna Helper" if you'd like to be added to that list, for weekday volunteer opportunities a few times a month.)
Date(s) that you are volunteering*
Special Construction Skills

This is not necessary, as Hosanna Industries will provide all of the necessary training for the project, but if you have any skills that might be helpful, please let us know.
Age (at the time of volunteering)*

Parental Consent (if volunteer is under the age of 18)*
- My son or daughter has my consent to perform volunteer construction work with Hosanna Industries, Inc.
Name of Parent/ Guardian (if volunteer is under 18 years old)*
First Last
Phone Number of Parent*

Medical Consent*
- Hosanna Industries, Inc. has my permission to administer or have administered any medical attention necessary in the event of accident or injury.
Insurance Carrier*

Hosanna Industries' volunteers must have medical coverage. In the event of an injury, volunteers must present their own medical insurance information to the doctor or medical service that will be treating you.
Special Medical Considerations
Date of your last Tetanus shot*
Month
Day
Year

If more than 10 years have transpired since your last tetanus shot please get a booster before you visit with us.

Are you staying in Hosanna Industries' dorm?*
- Yes
- No
In accordance with PA state laws, Hosanna Industries requires all volunteers over the age of 18 to have proper clearances in order to stay in our dorm.
Please check one.*
- I have lived in Pennsylvania for 10 years or more.
- I have lived in Pennsylvania for less than 10 years.
This information is used to determine which clearances are required according to the Pennsylvania Child Protection Laws.

Photo Release*
- I, the undersigned, permit use of photos and/or video images portraying myself in publications promoting Hosanna Industries, Inc.
Liability Release*
- I hereby release Hosanna Industries, Inc. (as well as its successor(s) and assigns) from any and all claims for damages, whether to person or property, arising from any accidents or injuries, direct or indirect, including travel to and from the day’s activities, which are caused or arise from my participating/ volunteering with Hosanna Industries, Inc. work project(s).
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