Clark County Dept. of Emergency Management 
710 W 13th St; Vancouver, WA 98660-2810


Please complete this application form if you are interested in becoming a Clark County, WA volunteer. Once you complete the form, click the Continue button at the bottom.


Site


Name and address


Personal Information

This identification information is required for our records but is not visible on your card.



Background Check

A background check will be run as part of the qualification and approval process. While a negative result will not be cause for automatic disqualification, please brief the program coordinator in advance on anything that may raise a red flag. 



In the event of an emergency, please notify:


Verification of Information

I understand that checking this box and typing my name constitutes a legal signature affirming that the above entered information is true and accurate to the best of my knowledge.