2019-2020 Disaster Worker Survey
All public school employees are mandated by the state to be workers during emergency and disaster situations. State employees, including teachers, can be kept during emergency situations for up to 72 hours following the emergency. This survey helps us develop the order of release in those situations.
Email *
Name: *
Position/Job Title: *
Room or Location: *
Days on Site: *
Cell Number:
Are you CPR certified? *
Are you AED certified? *
Are you First Aid certified? *
Do you have any other safety/health training?
Do you have elderly relatives at home to care for? *
Do you have children under 18 at home to care for? *
If you have children, list their ages:
In an emergency -- CONFIDENTIAL: *
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If you answered yes to the above question, please describe special health needs or medications:
If needed, describe other considerations we should be aware of in an emergency situation:
Are you willing to fulfill a role on the safety team and have a job to perform in actual emergency situations?
Job title and responsibilities will be cleared with you ahead of time.
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