VOLUNTEER ARMY QUAKE HELP REQUEST FORM

If you need assistance with non-life threatening tasks such as silt or debris removal please complete this form. For anything life threatening, dial 111.

*First Name:
*Last Name:
*Phone:
Mobile:
Email:
*Address:
*Suburb:
Depth of Silt:
Approx Coverage m²:
Why are you unable to remove it yourself?
Do you have equipment?	Shovel Wheelbarrow Other
Would small machinery (digger/dingo etc) be more suitable?	Yes No
Description:
Desclaimer:	Please be aware that as any assistance you receive will be provided by volunteers, the Student Volunteer Army and associated parties and these persons have absolutely no responsibility or liability for any damage or problems caused at this time, or in the future, by the use of machinery on your property whatsoever. By giving your consent to the use of machinery on your property, you recognise and accept this.
Read and understood the disclaimer:	Yes No