EMERGENCY MEDICAL TASK FORCE REGION 7 MEMBERSHIP FORM
FIRST NAME: *
Your answer
LAST NAME: *
Your answer
HOME ADDRESS: *
Your answer
PRIMARY PHONE NUMBER: *
Your answer
PRIMARY EMAIL: *
Your answer
AGENCY: *
Your answer
LICENSE/PROFESSIONAL TITLE: *
Your answer
ARE YOU A NEW OR CURRENT MEMBER OF EMTF7? *
DO YOU HAVE AT LEAST TWO YEARS' OF EXPERIENCE UNDER THE LICENSE/PROFESSIONAL TITLE YOU PROVIDED? *
DO YOU HAVE A COMPLETE TDVR (TEXAS DISASTER VOLUNTEER REGISTRY) PROFILE? *
HAVE YOU COMPLETED NIMS (NATIONAL INCIDENT MANAGEMENT SYSTEM) 100, 200, 700, 800? *
HAVE YOU ATTENDED THE EMTF-7 DEPLOYMENT BASICS COURSE? *
DO YOU UNDERSTAND THAT TEAM TRAINING, AS WELL AS OCCASIONAL WORK DETAILS, MOBILIZATION DRILLS AND QUARTERLY MEETINGS ARE REQUIRED? ARE YOU ABLE AND WILLING TO ATTEND THE ABOVE? *
DOES THE AGENCY YOU WORK FOR AND PROVIDED ABOVE, HAVE AN MOA (MEMORANDUM OF AGREEMENT) WITH CATRAC/EMTF7? *
HAS YOUR EMPLOYER AGREED TO SUPPORT YOUR MEMBERSHIP WITH EMTF7? *
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