KHERN Membership Form
KHERN’s general membership is free, volunteer-based, and open to any individual or organization showing interest in KHERN who can dedicate time, resources, or expertise to respond in the event of an incident or emergency in the state of Kentucky.

Please fill out the form below and we will be in touch with email announcements, alerts, and KHERN workshops, training and events.
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Email *
Email *
Name (First and Last) *
Phone Number *
Affiliation (Name of Organization, Institution or Business) *
Job Title *
Where are you and/or your organization located? (City, State) *
How did you hear about us? *
Which option(s) best describes you? Check all that apply. 
Which option(s) best describes your organization? Check all that apply.

What experience do you have with any of the following response/recovery specialties? Check all that apply.

*
Required
Please list any additional details we should know about your expertise and skill set (not required):
Would you/your organization be willing to be contacted and, if available, provide aid or resources to a fellow arts and cultural organization in the case of a crisis or emergency? (Potential resources include: physical space to store items, large freezers, mental health recovery support, staff that can volunteer, etc.)

If yes, you will be added to our list of responders to contact should an emergency or disaster occur.
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