Inglewood Community Membership skills form
Enter all your details. They will be entered in our community emergency plan but will be kept confidential from the public.
Name: *
Your answer
Physical address: *
Your answer
Number of people who live at this address: *
Your answer
Home phone number: *
Your answer
Mobile phone number *
Your answer
Email address: *
Your answer
Alternate contact person name and phone number(s):
Preferably someone outside the local area who could be contacted in an emegency
Your answer
Extra assistance required:
Some people our community are more vulnerable than others and may require extra assistance in an emergency event. Please let us know if anyone in your household or a neighbour may require extra assistance in an emergency event.
Your answer
Skills:
In an emergency, it is often those in the community who are there to help the community to get through. We know our community best and we are often right at hand to provide assistance to our neighbours. Please let us know of any skills you or a member of your household have and how you may be able to assist us in an emergency.
Your answer
Resources:
What resources and/or equipment do you or a household member have that you could use to assist our community in an emergency?
Your answer
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