Name *

First Name

Last Name

Email *

Phone *

Country

(###)

###

####

SMS Opt-in *

Anemoi Incident Response may occasionally communicate with its volunteers via SMS text message, including reminders about deployments, meetings, updates about your application, etc. Message and data rates may apply. Message frequency varies. Reply "STOP" at any time to notify us of your change in preference.

Yes! I would like to Opt-in and receive SMS messages from Anemoi.

No. I do not wish to Opt-in.

What is your home address? *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

What type of volunteer work are you interested in?

Check as many as apply.

Debris clearing (chain saw/manual labor)

Communications (amateur radio/Zello dispatching)

Floodwater Search & Rescue/Transport

Logistics/Supplies

Social Media

Weather Team/Storm Spotter

What types of equipment do you own that you would be willing to use during this deployment? (computer, comms equipment, chain saws, compact/subcompact front end loader, etc.)

Are you willing to deploy during disasters?

Yes

No

When is a good time for us to call? Anytime 9AM-Noon CST Noon-3PM CST 3PM-6PM CST 6PM-9PM CST

Emergency Contact *

First Name

Last Name

Country

(###)

###

####

Have you ever been convicted of a felony, had a personal protection order (restraining order) placed against you, or been convicted or involved in sexual harassment or assault, child/elder abuse, or substance abuse? *

(Answering this question in the affirmative does not automatically disqualify you from participating in disaster relief efforts with Anemoi.)

No.

Yes; explained below.

If your answer to the previous question was "yes," please explain in detail.

Please read the following carefully. *

As a volunteer of our organization, I agree to abide by the policies and procedures established by Anemoi leadership. I understand that I will be volunteering at my own risk and that the organization, its employees and affiliates, cannot assume any responsibility for any liability for any accident, injury or health problem which may arise from any volunteer work I perform for the organization. I agree that all the work I do is on a volunteer basis and I am not eligible to receive any type of monetary payment or reward for my work. Checking the box below and submitting this form indicates that you have read and agree to these terms.

I understand and agree to these terms.