Volunteer Hourly Work Sheet Name(Required) First Last Address(Required) Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email(Required) Phone(Required)Fire Safe Council(Required)Select FSCAmerican Canyon FSCAngwin FSCAtlas Peak FSCBerryessa Estates FSCBerryessa Highlands FSCBerryessa Knoxville FSCBerryessa South FSCBerryessa West FSCBlue Ridge FSCCalistoga FSCCapell Valley FSCCarneros FSCCircle Oaks FSCCoombsville Wildhorse FSCDeer Park FSCDiamond Mountain FSCGordon Valley FSCHennessey Rector FSCLake Hennessey FSCMt. George FSCMt. Veeder FSCNapa East FSCNapa Valley FSCNapa West FSCPope Valley FSCSilverado FSCSkyline Jamison FSCSoda Canyon FSCSpring Mountain FSCSt. Helena FSCHours WorkedDwelling Unit/HomeExamples include: Removing pine needles and leaf litter from roof and gutters, replaced vinyl gutters with metal gutters, ignition-resistant exterior improvements, installing screening on vents, flammable items removed from under decks and porches, inspect roof and replace missing shingles, etc.Landscaping (0—100 ft from base of dwelling unit)Examples include: Installation of hardscaping, replacing combustible mulches with stone/gravel options, tree and shrub removal, raking and removal of pine needles, leaves, ground litter/debris, tree trimming/limbing, moving firewood, lawn and native grass maintenance, etc.Common Area(HOA or other Homeowner jointly owned property within the site boundary) Activities include: Tree thinning, mastication and brush removal, grass maintenance, fire break construction, etc.MiscellaneousMeetings, presentations, program administration, home site visits, etc.Money SpentChipper Costs: Purchase/rental, fuel & oil, disposal fees, etc.Other Equipment Costs: Chain saw purchase/rental, power equip. purchase/rental, hand tools, protective equipment, etc.Contractor Costs: Arborists, landscapers, professional forestry services, debris removal, etc.Home Improvement Costs: Roofs, decks, windows, vent screening, retrofits, etc.Landscaping/DIYMiscellaneousVehicle mileageAdditional Notes
