DRO - Disaster Services Volunteer Registration

Disaster Relief Operation
Disaster Services Volunteer Registration

To streamline the registration process for volunteers from various community and faith based organizations during Disaster Relief Operations the four American Red Cross chapters which make up the Canopy Oaks Region have established this On-Line Disaster Services Volunteer Registration System.

When you are contacted either VIA phone or e-mail please register to volunteer using this on-line registration system. You will then be contacted with specific deployment instructions.

Canopy Oaks Region Information

Information on the American Red Cross Canopy Oaks Region can be found at the following web site:

Document Format

Canopy Oaks Region HTML

Point Of Contact Information
First Name:
Last Name:
Middle Name:
Preferred Name:
Address:
City:
State:
Zip:
Primary E-Mail Address: (Required)
Secondary E-Mail Address:
Day Phone Number:
Evening Phone Number:
Fax Phone Number:
Mobile Phone Number:
Pager:
Affiliation - Organization / Church You Are Affiliated With
(Only check one button under either organization or church)
Organization:	211 Big Bend Amateur Radio American Red Cross - Capital Area Chapter American Red Cross - Colquit County Chapter American Red Cross - Georgia Wiregrass Chapter American Red Cross - Valdosta Chapter America's Second Harvest (Food Bank) Big Bend Disaster Animal Response Team Boy Scouts of America Girl Scouts of the USA National Association for the Advancement of Colored People Volunteer Leon Woodment of the World
Other Organization:
Church:	AME Church Baptist Church Catholic Church Methodist Church Missionary Baptist Church Mormon Church Presbyterian Church Primitive Baptist Church
Other Church:
Function - Area You Are Willing To Volunteer In
Functional Choice:	Communications Damage Assessment Family Services Health Services (Nursing) Logistics Mass Care (Feeding) Mass Care (Sheltering) Mental Health Services Spiritual Care Services
Availability - When Can You Volunteer
Indicate Times And Days Available: (Sample - Hours Available 9:00AM - 7:00PM, All Day or Any Time)	Hours Available Monday Hours Available Tuesday Hours Available Wednesday Hours Available Thursday Hours Available Friday Hours Available Saturday Hours Available Sunday
Personal Information
Date Of Birth:
Race / Ethnicity:	American Indian / Alaska Native Asian / Pacific Islander Black Hispanic White
Gender:	Male Female
Veteran Status:	Disabled Veteran Veteran Vietnam Veteran
Marital Status:	Single Married Divorced Widowed
Spouse's Name:
Licenses, Skills & Languages
Employer:
Occupation:
Professional Licenses:
Special Skills:
Languages Spoken:
Emergency Contact Information
Name:
Address:
City:
State:
Zip:
Day Phone Number:
Evening Phone Number:
Code Of Conduct
(For American Red Cross Volunteers Only)
Code of Conduct:	Yes No I fully understand the mandatory requirements indicated in the American Red Cross Code Of Conduct
Personal Statement Of Understanding
(For American Red Cross Volunteers Only)
Personal Statement Of Understanding:	Yes No I fully understand the mandatory requirements indicated in the American Red Cross Personal Statement Of Understanding
Disaster Health Information
(For American Red Cross Volunteers Only)
Please download, print and complete the Disaster Health Information Form. When you are asked to deploy please bring the from with you the the chapter's Staffing Center or fax it to the chapter's Emergency Operation Center in Tallahassee at 850/878-6602.

Last Update: