This page is for chapter members use only.
If you are not already registered with the local chapter
you can apply to become a local volunteer by cklicking  here. 

Availability, Add new record

 

VOLUNTEER AVAILABILITY FORM

 

This page is the QUICK FORM, to be used only by volunteers who are ALREADY REGISTERED with the Southwest Georgia chapter, for purposes of letting the chapter know of your days and times that you are available for a particular operation, and what resources that you have available to assist in the operation.

 

Today's Date and time:   9/9/2010 1:40:31 AM

DSHR Number if you have one  

Last Name *

 *

First Name *

 *

Middle name

Disaster operation for which you are available *   *
What is your PRIMARY Activity?*  *

 

If desired operation is not on list above, or notes about your activity level, please specify:  

Day phone  Night Phone Cell E-mail
Availability - When can you work.  Choose as many as apply

Mon AM

Mon PM

Tues AM

Tues PM

Wed AM

Wed PM

Thurs AM

Thurs PM

Fri AM

 Fir PM

Sat AM

Sat PM

Sun AM

Sun PM

Resources - Do you have any special equipment or resources that would help with this operation?
Pickup truck Passenger Van 4 wheel drive Generator
 Spare Cell Phones    Storage Trailer    Large Van truck    Laptop computers  
 Tent  / Camper    Sleeping Bag    Air mattress    Copier  
 Fax Machine      Refrigerator    GPS    Digital Camera  
  Ice Chest    Ham Radio    FRS Radios      
If you wish to be deployed to a National Event, how long would you be able to stay away from home?

Other available equipment

 Special Comments

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