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Forms CEMA Volunteer Profile Questionnaire

Personal Information

Title:

First Name:

MI:

Last Name:

ID #:

Address:

City:

State:

Zip:

Mobile Phone #:

Home Phone #:

Work Phone #:

Fax #:

Email Address:

Preferred Method of Contact:

Emergency Contact Information

Contact's Name:

Mobile Phone #:

Home Phone #:

Work Phone #:

Legal

Have you ever been arrested for, charged with, or convicted of any offense(s)?\

If yes, please explain below:


Applicants that have been convicted of a felony will not be allowed to participate in the Chatham County Community Emergency Response Team.

Emergency Response Experience

Place a check next to all the areas that you have past experience (other than CERT):

CERT Program

Computer / IT Operations

Fire Safety & Suppression

Administrative / Clerical / Finance

Hazardous Materials

Special Needs Education / Awareness

Healthcare (Nursing, Physician)

Phone Operations

Search & Rescue Operations

EOC Operations

Incident Command System Operations

Public Relations

Counseling

Logistics Coordination

Exercise Design

Shelter Management

Cooking

Accounting

Facility/Warehouse Management

Fork Lift Operation

Resource Tracking

Web Site Design

Certifications

Please list all certifications that you hold (please send a photocopy of each certification to CEMA):

Please list all languages that you speak:

Computer Skills

Please list any computer skills you have:

Office Skills

Please list office skills that you have including administrative, clerical and accounting:

Availability

Please list your availability to respond to emergency situations (such as before/during/after hurricanes, tornado response, explosions, during weekends):

Please list your availability to participate in non-emergency situations (such as volunteer presentations, disaster exercises, conferences, etc.):

Restrictions

Please list any restrictions you may have to participate in CEMA volunteer activities:

Thank you so much for your interest in becoming a CEMA Volunteer.

Active Incidents

No Active Incidents

Weather Watches/Warnings

Excessive Heat Warning issued July 30 at 11:07AM EDT expiring July 30 at 9:00PM EDT by NWS Charleston http://www.weather.gov/chs

National Threat Advisory

thread condition

Savannah GA Weather

Partly Cloudy and 97 F at Savannah International Airport, GA
Partly Cloudy
Winds are Northwest at 8.1 MPH (7 KT). The pressure is 1011.2 mb and the humidity is 46%. The heat index is 107. Last Updated on Jul 30 2010, 12:53 pm EDT.

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