Newburgh Preservation Association
Dutch Reformed Church Restoration Committee
P.O. Box 206
Newburgh, NY 12551


Name __________________________________


Address _________________________________


City ____________________________________


State ____________ Zip ____________________


Email ___________________________________


Phone 1 _________________ [ ] Days  [ ] Evenings


Phone 2 _________________ [ ] Days  [ ] Evenings


Previous volunteer experience ________________________________________________


Skills/area of interest _______________________________________________________


Hours/month available: ______________  [  ] Weekdays   [  ] Evenings   [  ] Weekends

Committee interest:

[  ] Building

[  ] Events

[  ] Fundraising

[  ] Grants

[  ] Membership

[  ] Greeters & Guides

[  ] Landscaping/Grounds

[  ] Public Relations

[  ] Special Events

Comments:






Please print this form, fill it out, and send it to the address above.