IEEE MOVE Volunteer Support Survey
Thank you for your engagement with the MOVE Community Outreach program. It is through the diverse efforts of volunteers like you that make this program possible. Information you provide will allow us to appreciate your talents and time so we can best engage you in the program.  

Your completion of this survey is totally voluntary and we ask that you read the IEEE policies regarding privacy of the information you provided and indicate "accept" below.

Thank you.

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Email *
First Name *
Last Name *
Secondary Email Address (Optional)
Are you an IEEE  Member?  

Membership in IEEE is open to individuals who by education or experience give evidence of competence in an IEEE designated field. The designated fields are: Engineering, Computer Sciences and Information Technology, Physical Sciences, Biological and Medical Sciences, Mathematics, Technical Communications, Education, Management, and Law and Policy
*
IEEE Member Number
Please read the IEEE Terms & Conditions: https://www.ieee.org/about/help/site-terms-conditions.html and Privacy Policy:  https://www.ieee.org/security-privacy.html  I have read and agree. *
May we contact you directly? *
IEEE Region *
IEEE Section
Phone number where we can contact you
City (where you are based now) *
State (where you are based now) *
Your interest (you may answer more than one) *
Required
How much time can you dedicate?
*
Do you have any restrictions that would impact your ability to deploy?
Would you like additional information on how to participate in the MOVE program?
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Are you an Amateur Radio Operator? *
If yes, what is Call Sign and Operating Class?
Are you currently a Red Cross Volunteer? *
If Yes, please provide your Red Cross Volunteer number
Red Cross GAP(s) and last time you took DST 101 class
Have you completed the IEEE MOVE Operations class? *
Date you completed Operational class  (approximate)
MM
/
DD
/
YYYY
Have you completed Hands On Truck Training *
Date you completed Hands On Truck Training (approximate)
MM
/
DD
/
YYYY
Suggestions or Comments?   Anything else you would like us to know about yourself? Involvement with IEEE? Society & Council participation? Specialized skills? Your relationships and networks? Experiences that will be an asset to the program? Tell us how you can help the MOVE program global expansion.
A copy of your responses will be emailed to the address you provided.
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