Emergency Management
Please complete this application form only if you are interested in becoming an official CERT/AuxCom/MRC volunteer with Marion County Emergency Management.
As an official volunteer with these specialized teams, you will be expected to attend regular meetings, stay up to date on training and be available for occasional team response in the community. If you are only interested in receiving training but not interested in becoming a regular team member, please DO NOT fill out this form. (You do not have to be an official volunteer to participate in community training.)
Once you complete the form, click the CONTINUE button at the bottom.
Contact Information
First name:
*
Last name:
*
Nickname:
Street 1:
Street 2:
City:
State:
Choose
OR
WA
Zip:
Home phone:
OK to call me here
Work phone:
OK to call me here
Cell phone:
OK to call me here
Ok to text?:
First name:
Last name:
Home phone:
*
Cell phone:
*
Relationship:
Choose
Aunt
Boyfriend
Brother
Caregiver
Cousin
Co-worker
Daughter
Doctor
Domestic Partner
Family
Father
Fiance
Friend
Girlfriend
Granddaughter
Grandparents
Grandson
Homestay Mother
Husband
In-Laws
Landlady
Legal Guardian
Mother
Mother-in-law
Neighbor
Niece
Parents
Partner
Pastor
Religious Leader
Roommate
Significant other
Sister
Son
Spouse
Supervisor
Vocational counselor
Wife
E-mail
We like to keep volunteers informed of important news, schedules, and volunteer opportunities by email, however we will not send you any email you prefer not to receive. Use the checkboxes below to select the kinds of email you would like to receive from us.
Email address:
*
What kinds of email would you like to receive?
Recruitment appeals
General Correspondence
Schedule reminders
Why do you want to volunteer?
Do you have a certain skill/talent you want to share? Are you hoping to develop skills and learn new things? Do you just want to help your community? Please share the reasons why you are interested in volunteering.
Assignment Preference
Which team are you interested in volunteering with?
Specify CERT team (ESSNA, Keizer, Mt Angel, North Marion, Silverton, Stayton, Woodburn), ARES, or MRC
Skills & Experience
In which areas do you feel you have moderate to excellent skill? List all that apply.
Education/Special Certifications
List all that may apply. (If you are an Amateur Radio Operator, please include call sign).
Previous Volunteer Experience
Have you volunteered in other organizations? If so, where and what did you do?
Employer
Please list your current or most recent employer, if applicable.
Employer name:
Street 1:
City:
State:
Choose
OR
WA
Zip:
Demographic Information
You may optionally provide the following information. Some of our volunteer positions require a minimum age; date of birth is only used to match to appropriate volunteer positions.
Date of birth:
Month
Jan
Feb
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Apr
May
Jun
Jul
Aug
Sep
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Dec
Day
1
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Year
2022
2021
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1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
1919
1918
1917
(year optional)
18 or Older:
12-17 yrs old Permission Form Required:
I Agree
I understand that submitting this application form does not automatically register me as a Marion County volunteer and that there may be certain qualifications I must meet, including the acceptance of established volunteer policies and procedures, before I may begin volunteering.
By submitting this form, I agree that the information I have provided on the form is true and accurate.
I Agree
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