JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Be Red Cross Ready Presentation Request Form
Please fill out the fields below in order to request a virtual Be Red Cross Ready presentation. One of our team members will be following up with you shortly to discuss scheduling.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Your Name (First and Last)
*
Your answer
If you are requesting this presentation for a specific group, what is the name of your group?
Your answer
Please indicate below the date that you would like a Be Red Cross Ready presentation to be scheduled.
*
MM
/
DD
/
YYYY
Please indicate below the time (CST) that you would prefer the presentation to start. Presentation length is customizable.
Time
:
AM
PM
How many adults plan to attend the presentation?
*
Your answer
From which city, state will you and/or your group be joining us?
*
Your answer
Are there specific hazards you or your group would like to learn about?
Home Fires
Earthquakes
Hurricanes
Floods
Tsunamis
Tornadoes
Wildfires
Extreme Heat
Thunderstorms
Landslides
Winter Storms
Volanoes
COVID-19
Preparedness for Older Adults
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
