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


Name and address


Demographic Information

You may optionally provide the following information. It is used only to help us get a better idea of the demographic make-up of our volunteers.



Availability

Please indicate the days and times you are usually available to volunteer.



Email Preferences

We like to keep volunteers informed of important news, schedules, and volunteer opportunities by email! Please select the emails you prefer to receive.



Skills


Reference


Emergency Contact


Background Check

Please write yes or no if you have a background check and what date was it conducted on and who holds it.



Agreement

As a volunteer, I agree to abide by all applicable rules and regulations of the Clay County Emergency Operations Center.


I hereby authorize Clay County Emergency Management to check my references.


I certify that the information provided on this application is true and complete. I understand that any misrepresentation or omission of facts on this application could be cause for rejection or dismissal.


I understand that after I submit my application it will be reviewed by the Volunteer Coordinator. Upon receipt of notification from the Volunteer Coordinator, I agree to attend any required Volunteer Orientations and on-site training.