Operation Medical Shelter 2011 (RSVP)
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1. Operation Medical Shelter 2011 RSVP
Please fill out the following simple information to RSVP. Thanks
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1
. Please fill out the following RSVP, so that we will be able to send you correspondence related to our event.
Thanks
Please fill out the following RSVP, so that we will be able to send you correspondence related to our event. Thanks
First Name
Last Name
City/Town:
Email Address:
Phone Number:
2
. Which First responder/First receiver group are you most closely affiliated with ? (This is not a public event)
Which First responder/First receiver group are you most closely affiliated with ? (This is not a public event)
ACS
Board of Supervisors
CALEMA
California National Guard
CDC
CERT
EMSA
Fire Department
Hospital
Medical Reserve Corps
Military
Nursing School
Public Health
Sheriffs Department
STATE EPO
Ventura County Red Cross
Other (Geographic/affiliation)
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3
. We are interested in knowing which days of our event you intend to participate in.
We are interested in knowing which days of our event you intend to participate in.
Day One (May 9th) - Setup 0700-0700
Day Two (May 10th) 0700-0700
Day Three (May 11th) MCI Scenario 0700-1900
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4
. Are you interested in Being a "Victim" for our Mass Casualty Exercise (May 11th from 0700-1230)?
Are you interested in Being a "Victim" for our Mass Casualty Exercise (May 11th from 0700-1230)?
Yes
No
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