VC-VOAD Membership Application
VC-VOAD is a collaborative of local non-profit agencies, faith-based organizations, volunteer groups, public institutions, and private entities dedicated to improving outcomes for people affected by disasters. VC-VOAD helps communities respond to and recover from major disasters by facilitating cooperation, communication, coordination, and collaboration. 

In order to complete the membership application, you must pay the yearly membership. Dues paid to VC-VOAD will be used to cover state/national dues, guest speakers, expenses, and or other administrative costs.  

Please make checks payable to:
United Way of Ventura County/VCVOAD

They can be submitted at any meeting
or by mail to :
VC-VOAD
C/O United Way of Ventura County
Attention: Susan Englund
702 County Square Dr. #100, Ventura, CA 93003                                                                                      

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Email *
Organization Information
Organization Name *
Street Address (Street, City, State, Zip Code)
Mailing Address (Street, City, State, Zip Code)
Office Phone
24-Hour Emergency Phone
Fax
Website
Email
Membership Category
Clear selection
Contact Information
State the name and contact information of the main and secondary contacts for VC-VOAD. These individuals must provide complete information for each category and be willing to be reached at any time in the case of emergency.
Primary Contact
Name
Street Address (Street, City, State, Zip Code)
Emergency Phone
Home Phone
Work Phone
Cell Phone
Fax
Email
Secondary Contact
Name
Street Address (Street, City, State, Zip Code)
Emergency Phone
Home Phone
Work Phone
Cell Phone
Fax
Email
Mission Statement
Please provide the organization's mission statement. Include information on disaster programs if applicable.
Does your organization have a written Emergency Action Plan to protect life and property
Clear selection
Does your organization have a written Disaster Response Plan to respond to community needs?
Clear selection
Available Resources
Please indicate what types of resources and services may be available through organization. (Check as many boxes that apply)
Preparedness/Mitigation
Response/Relief
Recovery
Material Resources
Please list types of items that your organization may be able to offer to the community in times of disaster. Examples: buses, trailers, facilities and other locations that could serve as a collection site or for clothing, ham radios or support coordination of housing assistance and other disaster relief services.
Could your facility be used as a shelter?
Clear selection
If yes, what is the capacity?
Access and Functional Needs Provision?
List of items your organization may be able to offer to the community in times of disaster
Human Services
Please list the number of staff/volunteers your organization would have available to help in times of disaster and their special skills or training. Examples: 5 caseworkers, 4 truck drivers, 6 childcare workers.
Spontaneous Volunteers
How would your organization use spontaneous volunteers?
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