Volunteer Intake Form

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Thank you for your interest. SafeTechSBC is a 100% volunteer-based organization. We are looking for individuals that want to get involved. The work we do is immediate, direct and will have benefits to our community's quality of life for years to come. Remember, one of the best ways to offset fear, hopelessness, frustration or anger is through direct positive action. For questions about SafeTechSBC or this form contact us at info@SafeTechSBC.org

Name *

Home Address

Phone

Email Address *

City *

Zip Code *

Workplace (if this is the location of concern)

What best describes your primary reasons for wanting to be involved with SafeTechSBC? *

I live within a block of an existing cell tower (Wireless Telecommunications Facility - WTF)

I live close to where a proposed new cell tower location (WTF)

I work close to an existing cell tower (WTF)

I work close to a proposed new tower location (WTF)

I don't know if I live or work close to a proposed or existing cell tower (WTF)

I want to help educate people about the harms of Radio Frequency Radiation (RFR)

I want to be a cell tower location coordinator (organize a removal or denial of a proposed tower)

I have Electro Magnetic Sensitivity (EMS)

I have an existing health condition that puts me at greater risk to exposure to RFR

Someone in my household has EMS (Electro Magnetic Sensitivity) or has an existing health condition

I want to help stop or slow the expansion of WTFs

I know someone with EMS

I want to help reduce RFR exposure at schools and day care centers

I am interested reducing my RFR exposure

I am a tech-oriented person interested in learning about alternatives to wireless technology

Other:

Required

What kind of volunteer activities are you interested in?

Public comments at hearings (City Council, Board of Supervisors, Architectual Review Boards, etc)

Education programs

Social media

Reviewing WTF permit applications for errors and omissions

Researching solutions like Fiber Optic to the Premises (FTTP) and other healthier tech alternatives

Working with schools, teachers and educational administrators to reduce RFR exposure

In-person outreach at Farmers Markets or in neighborhoods with proposed or existing WTFs

Spanish outreach (written, oral)

Telecom ordinance work (critiquing, proposing new language, reviewing other city's telecom ordinances)

Strategic planning

Fundraising

Legal counsel

Track and document the health impacts of RFR in our community

Environmental and fire dangers of WTFs

Federal or State Campaigns and Legislation

Networking with other organizations that have overlapping goals with SafeTechSBC

Not sure how I can help but I am interested in being a volunteer

Join the SafeTechSBC Board of Directors

Administrative assistance

Other:

Do you experience any of the following symptoms regularly? These could be caused or aggravated by RFR exposure.

Dizziness or loss of coordination

Ringing in the ears (Tinnitus)

Fatigue

Headaches

Eye disturbances or cataracts

Autoimmune disorder

Brain fog, forgetfulness, confusion

Trouble sleeping

Body pain

Irritability or depression

Heart problems

Flu like symptoms

Cancer

Other:

Would you like to be added to our newsletter and email list?

Yes

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