Adult Leader Skill Level & Information Form

Adult Skill Level & Information Form
Dates attending the Jeremiah Project: *
Church Name *
Spelled out, no abbreviations
Name *

First Name Last Name
Address

Street Address

Street Address Line 2

City State

Zip Code
Cell Phone: *
Male or Female: *

Male Female
Medical & Dietary Concerns or Allergies? If yes, please explain. *
Please note any dietary concerns such as vegetarian
Have you attended a Jeremiah Project work camp before? *

Yes No
Have you attended other work camps before? *

Yes No
Please indicate your experience level in each of the following areas:
Carpentry

No Experience Limited Experience Handy Person Professional
Concrete

No Experience Limited Experience Handy Person Professional
Drywall

No Experience Limited Experience Handy Person Professional
Flooring

No Experience Limited Experience Handy Person Professional
Painting

No Experience Limited Experience Handy Person Professional
Roofing

No Experience Limited Experience Handy Person Professional
Using Power Tools

No Experience Limited Experience Handy Person Professional
Briefly describe any experience indicated above:
Check any reservations concerning the following:

Ladders Roofing Heavy Lifting
Work Site Management

A few of our adult leaders will need to serve as leaders on the work sites. You will be responsible for motivating your work team and guiding the students through the work tasks assigned by JP's Tool/Site Coordinator. You will have the opportunity to sit with the Tool/Site Coordinator the night before and discuss the scope of the project and how to accomplish the work.
Please select the phrase that best describes your comfort level with leading a work team on a work site: *
Should be Empty:

Adult Skill Level & Information Form