"On-Call Disaster Volunteer" Interest Form - Napa County - Formulario de Interes para ser Voluntario durante Desastres o "en guardia" para desastres para el Condado de Napa

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Please provide your information so that we can contact you when disaster strikes. Por favor llene este formulario para que puedamos comunicarnos con usted.

Email *

First Name / Nombre *

Last Name / Apellido *

What is your phone number? Numero de Telefono? (Cell) *

Do you prefer to receive information by email or text message? Prefiere comuncacion por correo electronico o mensaje de texto?

Email / Corre Electronico

Text Message / Mensaje de Texto

Either / Cualquiera de los dos

Other:

Clear selection

Check the appropriate box *

I am 18 years of age or older / Tengo 18 años o mas

I am under 18 years of age / Tengo menos de 18 años

Required

Where are you located? (Town or City) / En que ciudad vive? *

Are you able to travel to another city/town to help? / Puede viajar a otra ciudad o pueblo para ayudar? *

Yes / Si

Maybe / Tal vez

Other:

Which type of volunteer roles are you interested in potentially taking on? / En que tipo de rol o trabajo esta interesado? *

Do you have any physical limitations that might affect your ability to move equipment or heavy objects? / Tiene alguna limitacion fisica que afecte su habilidad de mover equipo o objetos pesados? *

Yes / Si

Other:

Are you bilingual in English & Spanish and are comfortable speaking to community members or staff in Spanish? / Es bilingue en Ingles y Espanol y se siente comodo hablando con la comunidad y trabajadores en Ingles y Espanol? *

Yes / Si

Other:

If you know another language and do you feel comfortable serving as an interpreter for others?

Yes

Maybe (depends on the situation)

Other:

Clear selection

If you said yes to the previous question, what other language(s) do you speak?

Would you like more information on any of the following topics? Some of these trainings we provide and some are provided by our partners. We will send you all the information you need for these.

Esta interesado en mas informacion de estos temas abajo? O le gustaria participar en entrenamientos de estos temas.

Emergency Volunteer Center Volunteer

CERT Training

Until Help Arrives Training

Listos Training

I want to help! But need more information on the different options.

Other:

Send me a copy of my responses.

Submit

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