Clone of Appalachia Group Sign-up Form

Please contact our office at AppalachiaAdmin@mcc.org
or (606) 634-4418 with any questions.

MCC Appalachia Build (formerly SWAP) is a home repair ministry program in eastern Kentucky and West Virginia. Volunteers help families make their homes safe, warm and dry, while building relationships and learning about Appalachia.

Please select the week and amount of spots you would like to reserve.

Current Weeks & Spots Available*

Cost to Attend is $400 per person, group downpayment is $800

Name of Church or Group*

Number of adults (over 18)*

Number of youth (age 13-17)

Number of adults and kids Totals

Group Leader Full Name*

First NameLast Name

Contact Email*

example@example.com

Contact Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

Address of Church or Group Leader*

Street Address

Street Address Line 2

CityState

Zip Code

Downpayment Amount*

Downpayment Calculation

Total Cost Per Person

Anything you want to add?

CheckCredit Card

Payment Amount*

USDDown payment amount

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Total people attending (Verification)

This is an automated field.

Please write your check to MCC US with the deposit amount of $800, and a note this is for Appalachia Build, Week, and Group name.

Individuals signing up the deposit/full amount is $400

Please mail the check to:

MCC US - Dan Zook

21 South 12th Street
PO Box 500
Akron, PA 17501-0500

Remaining Balance

Amount still owed

Error: Your selected week spots quanity is not equal to the total number of adults and children. Please verify the total reseved and try again.

Volunteer Group Sign-up