Reach Out America – Volunteer Skills Survey

Name*

Email*

Birthday

Over 18 years of age?

YesNo

Cell Phone

Yes, text me! I agree to receive recurring text messages from Reach Out America at the mobile number provided, including disaster deployment alerts, volunteer reminders, and relief updates. Msg frequency varies (about 2-8 msgs/month, more during active disasters). Msg & data rates may apply. Reply STOP to opt out, HELP for help. Consent is not a condition of volunteering, donating, or receiving assistance.

Address

Emergency Contact

Emergency Contact Name

Emergency Contact Phone

Skills Assessment

Position or service activity with current organization, if any

Special Skills, Training, Work Experience (please check the boxes that apply to you)

Accounting

Community Emergency Response Team

Chainsaw Operator

Child Care Worker

Clergy

Clerical

Commercial Driver's License

Counseling

Construction

CPR/AED Certification

First Aid Certification

Food Preparation

Elderly/Access and Functional Needs Care Worker

Forklift Operator

Amateur Radio Operator

Heavy Equipment Operator

Medical/Nursing

Shelter Management

Social Media

Social Services

Pilot License

Search and Rescue

Trucking/Hauling

Veterinarian

Volunteer Management

Warehouse/Inventory/Donations Sorting and Management

Access to and Trust of Underserved Communities

Other

Transportation (please check the boxes that apply to you)

I have a valid driver's license

I own a personal vehicle

I use public transportation only

Available Equipment and Resources (please check the boxes that apply to you)

Chainsaw

Citizens Band Radios/Walkie-Talkies

Four-Wheel Drive Vehicle

Amateur Radio Call Sign

Portable Generator or Solar Power

Trailer

Water Pump

Other

Language Skills

Please provide additional details about the skills and resources selected above

Upload a picture of your driver's license

Take a photo or choose one from your gallery. JPEG, PNG, WEBP, GIF, or HEIC. 10 MB max.

Email updates (optional)Yes, Reach Out America may email me follow-ups, reminders, and updates. I can unsubscribe at any time.

See our Privacy Policy.

Leave this field empty

Description

Reach Out America volunteer skills survey. Tell us how you can help: skills, transportation, equipment, and who to call in an emergency.

Reach Out America SMS Terms · Privacy Policy