Northwest New Mexico Emmaus Community

Rev. 7/21/12

Northwest New Mexico Emmaus Community

Survey and Volunteer Sign-up Sheet

Name:______

Address:______

City:______St.:______Zip:______

Phone #:hm______wk______cell______

Email:______

Age:_____ Birthdate:_____ Name of Spouse (if applicable)______

Church:______Are you an active member?______

Pilgrim Walk #:______Date of Walk:______Lay____ Clergy____

Community:______or Location of Walk:______

____Yes! I would like to serve on an Emmaus Walk support and/or conference room team in the future.

____ NO, I am not interested in serving on a team, but will pray for the continuing ministry of

the Walk to Emmaus. (continue to back of sheet, pg.2)

MUSIC: I would like to be involved as one of the musicians in the community and on Walks

____I play one or more musical instruments (list below)

______

____I do not play an instrument but can lead singing

CLERGY:

____I would be willing to serve as part of the clergy team for an Emmaus Weekend

CONFERENCE ROOM TEAM: (Lay Persons. Active participation in your local church and a Reunion Group is a pre-requisite for working Emmaus Walks)

____I would like to be on a conference room team

____I am currently active in the ______Reunion Group

____As a member of the NWNM Emmaus Community, I plan to be a part of a Reunion Group

BEHIND THE SCENES: I am willing to be a part of the weekend participation in the following ways: (check all that apply):

____72 Hour Prayer Vigil

____Prayer Agape Chapel- Come onsite and pray during the weekend

____Provide Agape (both food and table agape) for Walks

____Come to facility and help Outside Team distribute agape during the weekend

____Stay on site for the Walk weekend and be a part of the Outside support Team

____Be a part of the kitchen crew, if applicable

____Help with transportation

____Help Trailer Angels with setup on Thursday before the Walk begins

____Help Trailer Angels with cleanup on Sunday at the completion of the Walk

____Help inventory the trailer

____Childcare

____House out of town guest

____Be a part of one of the committees under the Board of Directors

____Be on the Board of Directors

PREVIOUS WALK EXPERIENCE: (This information is to be used for the purpose of future team selection. We are always updating our database and it is important to have accurate information)

Number of Walks worked______

Give Walk Dates and #s: ______

______

Positions Served:______

Talks Given:______

Please turn form to: NWNM Emmaus Registrar, P.O. Box 3624, Albuquerque, NM 87190

I understand that as part of an Emmaus Conference Room Team, I will be required to pay the same fee as a pilgrim pays. In the Outside Team support role, if staying on site, I will be responsible for paying for my room and meals.

Signature: ______Date: ______