Millard Fuller Legacy Build 2013 Registration

The fifth annual Millard Fuller Legacy Build will take place in Atlantic City, N.J., starting Sunday, April 28, 2013, with the kickoff dinner. The build days will begin Monday, April 29, starting at 7:30 am and ending each day at 5 p.m. Please complete the registration form below and after you hit "submit" it will take you to a secure page to make payment by credit card. If you prefer to make payment by check please mail your registration fee within 5 days to the address below. All fees must be received by April 10, 2013. In addition, you will need to send in your Emergency Contact Form and Release Waiver.
Mail payment and forms to:
Fuller Center for Housing
MFLB 2013
PO Box 523
Americus, GA 31709

Should you have any questions or concerns please contact Brenda Barton at brenda@fullercenter.org.

THANK YOU!

Last Name: *

First Name (One name only-please register second person separately): *

Email Address: *

Mailing address: *

City: *

State: *

Postal Code: *

Home Phone: *

Cell Phone:

Work Phone:

Year of Birth: *

Gender: *

Female

Male

Occupation:

Name of Group or Team (Optional):

Group or Team Leader (Optional):

Lodging-Please check where you will be staying: *

Host Hotel

Volunteer Lodging-No longer available/has reached its capacity

Other

Roommate request:

HOTEL ONLY: Please let us know if you would like to be matched with a roommate.

Although we will not be able to provide transportation to and from the airports we will glady take your flight information and share it with other volunteers that may want to share a ride.:

If you checked "other", please tell us where you will be staying:

Arrival Date: *

Departure Date: *

How are you arriving: *

Driving

Flying

Skills (Other):

Please describe other skills and/or building experience.

Level of Skill:

none

semi-skilled

very skilled

Bringing:

Will you have hand tools, tool trailer, other? Please let us know.

Do you have a special diet/or special needs?: *

What will you attend?:

Sunday, April 28, Kickoff dinner and celebration

Monday, April 29, Build Day 1

Tuesday, April 30, Build Day 2

Wednesday, May 1, Build Day 3

Thursday, May 2, Build Day 4

Friday, May 3, Build Day 5

Friday, May 3, Closing dinner and celebration

Will you be interested in pre-build or post-build opportunities?: *

Please provide us with your local newspaper(s), contact person/reporter, and phone number-we will be using this to help promote the Legacy Build:

Please check below if you would allow Fuller Center to share your contact information with other volunteers after the event: *

Any other additional information or comments:

Primary links