Iris Relief Volunteer Application
Please Note: Estimated time to complete application is about 30 minutes.
Email address *
Personal Information
First Name
Last Name
Current Address
Phone Number
Date of Birth
MM
/
DD
/
YYYY
Gender
Drivers License Number
Drivers License Classification
Drivers License Place of Issue and Expiry Date
Your Photo
Marital Status/Children
Current Occupation
Please include job description, place of work, work address, work contact number
Churches Affiliated With
Please include name of church, leadership role and responsibilities, and length of affiliation.
Languages spoken and can you be used as a translator
T-shirt size:
Health and Medical Information
Blood Type
Would you describe your health as
Would you describe your fitness as
Vaccination History
Please include a detailed list of your vaccinations with batch number/description, date received, and expiry date. Please indicate whether you have had the following vaccinations: Hep A & B, Tetanus, Typhoid, Yellow Fever.
Do you have any medical conditions, long standing injuries, serious allergies or are taking any regular medications (Other than vitamins, birth control or malaria prophylaxis)?
Please indicate the potential impact on helping in a disaster. (1 minimal, 5 serious)
Have you ever been treated for heat stroke or heat exhaustion?
Please describe when and severity.
Other
Please comment on any other aspects of your health that may impact your ability to helping during a disaster.
Please comment on your state of health.
Working in disaster zones can be physically and emotionally demanding. You may be on your feet for long periods of time, working and sleeping in environments that are not climate controlled, and if you have special dietary needs you may not be able to find certain items. Some of the work in disaster situations requires heavy lifting, working in extreme temperatures, and long hours. If any of this is not suitable please let us know. There are places that you will be able to serve such as food preparation, administration/logistics, inventory, and prayer teams.
Personal Assessment
Please give an account of your strengths
Please give an account of your weaknesses
What do you feel your Spiritual gifts are?
Please rate your skills/experience in the following areas: 1 being less, 5 being more.
Photography / Videography
Writing / Blogging
Technological / Multimedia Skills
Medical
Construction
Pastoral / Counseling
Children’s Work
Administration
Accounting
Planning/Strategy
Team Leading
Worship Leading
Prayer and Intercession
Team Work
Please rate the following statements: 1 not at all, 5 highly competent.
I work well in team situations
I willingly submit to directions given by my designated leader
I can delegate roles to get the job completed
I can see where needs are
I need to know my specific role and responsibility to function well in a team situation
I am flexible and able to move between different roles at a moments notice
I can delegate roles to get the job completed
How do you feel you work/cope as part of a team?
Certified Qualifications and Experiences
Please list all Certified Qualifications
Include the place of training, length of training, date completed, length of experience, and a description of your experiences.
Nation and City where you completed Basic CERT Training:
Crisis Response and Disaster Relief Training and Experiences
Please comment on any previous experience of international missions or in disaster zones.
Please check any of the following trainings you have had:
Please list the details of all previous training completed for disaster relief.
This can include Chaplaincy, CPR etc. Please include name of training, length of training, date completed, expiry date, where relevant, and if you received a certificate.
Please list all previous experiences in responding to disasters:
Include: Organization you were deployed with, nation deployed to, city/region deployed to, year of deployment, length of deployment, rolls and responsibilities. Also include a description of how this personal experience has impacted you.
Please comment on any specialty/special skills/ or relevant experience.
How do you feel you deal with Crisis situations and Trauma?
Any other information you would like to provide about previous training completed?
Spiritual Life
Church you attend regularly
Church Leader Name
Church Leader Phone Number
Church Leader Email
Please also give a brief account of your testimony/faith history
Iris Relief
Have you attended Harvest Mission or Holy Given School? Please state your school
If not an Iris Mission School Alumni, how did you find out about Iris Relief?
Why would you like to be part of an IRIS Relief response team?
Further Training Opportunities
Please check all areas you would be interested in completing further training
When you have completed your CERT training, there may be other opportunities for you to participate in more specialized training
Local Support
Please fill in the table below to show the areas you would like to be involved with at your local level during and directly following a disaster. Rate your skill level and availability below each area
CERT First Responder
No Interest
High interest
Skill level
Low
Advanced
Availability
Administrative and logistical Support
No Interest
High interest
Skill level
Low
Advanced
Availability
Team Support (caring for team needs such as food preparation)
No Interest
High interest
Skill level
Low
Advanced
Availability
Chaplaincy for team members
No Interest
High interest
Skill level
Low
Advanced
Availability
Chaplaincy for victims
No Interest
High interest
Skill level
Low
Advanced
Availability
Prayer support
No Interest
High interest
Skill level
Low
Advanced
Availability
Please fill in the table below to show the areas you would like to be involved with at your local level to prepare for a disaster and rate your skill level below each area
CERT Trainer
No Interest
High interest
Skill Level
Low
Advanced
Program Development
No Interest
High Interest
Skill Level
Low
Advanced
Community Development
No Interest
High Interest
Skill Level
Low
Advanced
Social Media Support
No Interest
High Interest
Skill Level
Low
Advanced
Public Relations
No Interest
High Interest
Skill Level
Low
Advanced
Grant Writing
No Interest
High Interest
Skill Level
Low
Advanced
Event Planning
No Interest
High Interest
Skill Level
Low
Advanced
Administrative support for training and community preparedness
No Interest
High Interest
Skill Level
Low
Advanced
Accounting
No Interest
High Interest
Skill Level
Low
Advanced
Fundraising
No Interest
High Interest
Skill Level
Low
Advanced
Team Building
No Interest
High Interest
Skill Level
Low
Advanced
Chaplaincy/Pastoral Care
No Interest
High Interest
Skill Level
Low
Advanced
Prayer/Intercession
No Interest
High Interest
Skill Level
Low
Advanced
Comments about helping at your local level
International Deployment
Are you interested in deploying outside the nation of your current training?
Please note: if you are interested in deploying outside the nation of your current training, you will be contacted and asked to complete an application form. Information requested will include passport details, availability to travel, and eligibility to travel (eg are you eligible to obtain visas for different countries including the USA?). You will also be asked to provide a resume and complete an international background check at your expense.
Please fill in the table below to show the areas you would like to be involved with when serving internationally during and directly following a disaster. Please rate the area of service, skill level, and availability
CERT First Responder during a disaster
No Interest
High Interest
Skill Level
Low
Advanced
Availability
CERT Trainer
No Interest
High Interest
Skill Level
Low
Advanced
Availability
Administrative and logistical support during a disaster
No Interest
High Interest
Skill Level
Low
Advanced
Availability
Administrative and logistical support for training and community preparedness
No Interest
High Interest
Skill Level
Low
Advanced
Availability
Team Support (eg: food preparation and service during a disaster)
Low Interest
High Interest
Skill Level
Low
Advanced
Availability
Chaplaincy (eg: debrief with team after responding to a disaster)
No Interest
High Interest
Skill Level
Low
Advanced
Availability
Worship and Prayer Support
No Interest
High Interest
Skill Level
Low
Advanced
Availability
Any other comments
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