Registration for PTN Volunteer Damage Assessment Team
This form is to register as a volunteer for any disaster in which we may be called upon to assist. PermitTechNation will maintain a list of volunteers and contact you if/when we are called upon.

If you are able to assist with remote data entry of damage assessment information, please complete this form.

Please provide the best email to be contacted at knowing that you may be contacted during non-working hours including nights and weekends.
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Email *
First Name *
Last Name *
Cell Phone (xxx-xxx-xxxx format only please) *
Alternate Phone (xxx-xxx-xxxx format only please) *
Mailing Address *
City *
State (abbreviation only please) *
Zip Code *
What Jurisdiction/Company do you work for? *
What type of information will I be entering? ATC-45 Damage Assessment Date

Will it be personal information related to individuals who have damage to their property? No Names, just property address and type of damage

How long will this go on? Work may occur for up to 1 month depending on how many disasters, amount of assessments. Volunteering can be for as many days as volunteer can participate.

Who will be sending emails to a jurisdiction email address? PermitTechNation

Will files be stored on the jurisdiction/home computer? No documents shall be stored; files shall be deleted after entry is completed into the Google Form.

What if my jurisdiction has problem with employees using jurisdiction time to do non-jurisdiction work and working evenings and weekends due to FSLA laws? This is on a volunteer basis. While it may not be for your particular community, it is a way to assist remotely. It requires no time out of the office or being put in harm’s way. It provides some hands on experience and training should the need arise in your community to perform these tasks. It’s a sense of pride and community for assisting others.
Will you be volunteering from home, work or both? *
If you are volunteering from work, do you have permission from your jurisdiction? *
Agree & Submit
By registering to volunteer, you agree to assist PermitTechNation with data entry as requested by affected jurisdictions at your own risk; with no compensation and you agree to hold harmless PermitTechNation from any issues that may arise from your participation. You agree to only enter data during your work hours with express permission from your jurisdiction. You agree NOT to share any of the forms or data you enter with anyone except with the PermitTechNation coordinators who assign you the file. You agree to immediately delete the damage assessment files upon completion and submittal of the data back to the PermitTechNation coordinator.

Note: Submittal of this form does not guarantee that you will be contacted for help. Due to high volume of emails and phone calls, once you have signed up to volunteer, please do not contact us. We will contact you if and when your services are needed. We appreciate your understanding and cooperation.
I AGREE to the terms set forth above and I request to be registered with the PTN Volunteer Damage Assessment Team *
A copy of your responses will be emailed to the address you provided.
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