Montgomery County Disaster Volunteer Survey
During a disaster, the immediate response and the initiation of recovery are vital to a community.  The ability to build a local base of volunteers in various areas ensures that Montgomery County is able to respond effectively and efficiently to those most in need after a disaster; along with ensuring that available resources are utilized to the fullest extent.

Montgomery County Office of Homeland Security and Emergency Management (MCOHSEM) would like to know if you are interested in serving as a volunteer during a disaster, and if so,  how would you like to serve?

*Due to the sensitive nature of active disaster response, we respectfully ask that volunteers be over the age of eighteen (18), unless a role indicates that it is appropriate for children/teens*
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General Information
General information of the individual/family
First Name *
Last Name *
Primary Phone Number *
Email Address
Current Street Address *
Current City *
Current Zip Code *
Date of birth *
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Are you affiliated with any church/congregation/organization that may do disaster response/recovery? Please list the name.
What geographical area do you prefer to serve *
Are there additional members in your family that plan to volunteer?
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If yes to the above question, please list the names and date of birth for additional family members who would like to volunteer.
Additional family member #1 first and last name
Additional family member #1 date of birth
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Additional family member #2 first and last name
Additional family member #2 date of birth
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Are you fluent in any languages
Do you posses any of the following professional credentials?  
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