Emergency Assistance Volunteer Registration
BERNARDSVILLE OEM 2020: COVID-19 HEALTH EMERGENCY. Please submit one form for EACH volunteer.

The information provided on this form is required for volunteer participation with the Bernardsville Office of Emergency Management. Thank you for your interest!
Email address *
Last Name, First Name [Initial] *
ex: Dawson, Linda R.
Your answer
Are you 18 years old or more? *
PLEASE NOTE: We are unable to accept volunteers who are not at least 18 years old.
Address *
Your answer
Mobile phone number
10 digits please
Your answer
Home phone number
10 digits please
Your answer
Where do you live and/or work? *
Required
Next
Never submit passwords through Google Forms.
This form was created inside of Bernardsville. Report Abuse