2019 Halloween Flood Volunteers
Early Response Volunteer team and individual intake information. Please enter your individual or team contact, availability, skills, and training information. Upper New York Disaster Response Coordinator Mike Block is working to find locations for housing and work. DO NOT DEPLOY on your own - doing so further burdens the community.
Email address *
FirstName *
Your answer
LastName *
Your answer
Organization *
Name of Church or organization you represent as a volunteer. Enter NONE if appropriate..
Your answer
Street *
Your answer
City *
Your answer
State *
Please enter 2 letters abbreviation. Example: NY for New York
Zip *
Enter 5 digit Zip Code
Your answer
Phone *
Your answer
Your answer
Volunteer *
Are you and/or members of your team Early Response Team (ERT) trained?
Leader *
Have you completed UMCOR Team Leader Training?
Experience *
Do you have disaster response experience?
Work *
What type of work are you prepared to do? Check all that apply.
Dates *
List dates you are available. Please be as specific as you can.
Your answer
Housing *
Do you need housing?
Females *
Indicate the number of Females on your team (including you if it applies.)
Your answer
Males *
Indicate the number of Males on your team (including you if it applies.)
Your answer
Enter any specialized equipment you are bringing. Examples: generator, trash pump, tool trailer, etc.
Your answer
Your answer
A copy of your responses will be emailed to the address you provided.
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