Union Park Stake                                                                                            Emergency Preparedness Survey
Survey of the Union Park Stake of the Church of Jesus Christ of Latter Day Saints. This form is to collect information about the skills, services and equipment that would be available to help in a crisis response. Any information collected will be used by the Union Park Stake and its accompanying wards only. No information will be shared with others.
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Name: *
Address: *
Phone: *
Adults in household: *
Children in household: *
Any family special needs?
Ward:
Please select the skills, services, and equipment you would be willing to volunteer to our community in the event of an emergency.
Equipment and tools:
Vehicles:
Medical skills:
Construction skills:
Other skills:
Communications:
Emergency situation skills:
Public safety:
Miscellaneous:
Other: Please specify
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