Radiation Monitoring Project (RMP) Application Form
Radiation Monitoring Project (RMP) was established to put radiation monitors into the hands of front-line communities affected by ionizing radiation, and provide them with professional training to collect accurate and credible radiation readings in their areas. We invite you to participate in this project. Please fill out the form below to apply for the project.

Email: radmonitoringproject@gmail.com
Mailing address:
Radiation Monitoring Project
227 E 7th Street Apt 7G
Brooklyn, NY 11218
http://radmonitoring.org

Your name *
Your answer
Organization name (if any)
Your answer
Email address *
Your answer
Mailing address *
Street Address, Apt, City, State, Zipcode
Your answer
Phone number *
Your answer
Section 1: To Be Part of this Project
Please type in your answer or check one of the boxes below. If you check other than YES, please explain your reasons in columns where applicable.
1. Please explain your community's radiation exposure problem or issue that you are actively working on (If you are completing this form on printed paper, please write a statement and submit as an attachment to this form). *
Your answer
2. You have explained a process to measure radiation and record data to give to RMP team. *
Required
2a. If you answered Yes above, to who?
Your answer
2b. If you answered No above, how did you hear about this project?
Your answer
3. You agree to undergo a complete training process (at least one full-day session). *
Required
3a. Training is one-full-day. Please choose your availabilty (check all applicable).
4. You are able to properly use and care for the Radiation Monitor *
Required
5. You agree to keep and record data, and regularly make the data available to the RMP. *
Required
6. You agree to return the monitor to the RMP when the issue has been resolved, or the organization/individual stops work on the defined problem/issue. *
Required
7. You will not lend, lease, sell or give away the monitor to another party *
Required
8. You agree to contact RMP for additional or further use of the RM outside of the use initially agreed to. *
Required
9. You are open to referring and involving others to the RMP *
Required
10. You can demonstrate that you do not have the financial means to purchase, lease or acquire a RM on your own. If "Other," please explain. *
Required
11. You are willing to work with the RMP to raise funds for their own work and future monitor, or additional monitors *
Required
12. You have the capacity to reimburse the RMP fully for any damage, loss or repair of a RM (The RMP will work on resolving any incidents on case-by-case basis). *
Required
Section 2: What the RMP Will Provide
1. Useof one, or an agreed upon number of RMs that are suitable for your needs, for an agreed upon period of time. *
Required
2. Training and limited support from our team for using your RM. *
Required
3. Some mutually agreed-upon travel-expense money for participants to come to the RM Training session(s). Others may attend at own expense. *
Required
4. A link to download data to; and a website where data can be viewed and obtained *
Required
5. Referrals to and contact information of radiation experts and labs *
Required
Section 3: About Your Project
To complete the application, please write a statement about your project. *
If you are completing this form on printed paper, please write a statement and submit as an attachment to this form.
Your answer
Section 4: Everything Else
Please fill in any questions and comments that you may have.
If you are completing this form on printed paper, please write a statement and submit as an attachment to this form.
Your answer
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