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* 1. Please fill out your contact information

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* 2. What is your preferred method of contact?

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* 3. What licenses and certifications do you have, and Which of the following Maine licenses do you hold CURRENTLY? (Please check all that apply)

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* 4. Which professional organizations do you belong to? (currently, in good standing)

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* 5. Have you completed Red Cross Disaster Training or other type of Disaster Training?

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* 6. Have you previously deployed or participated in the scene of an active disaster in Maine or elsewhere?

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* 7. How many hours per week can you volunteer?

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* 8. Desired Schedule (Check days/times available).

  8:00 a.m. to 12:00 noon 12:00 noon to 4:00 p.m. 4:00 p.m. to 8:00 p.m.
Monday
Tuesday
Wednesday
Thursday
Friday 
Saturday
Sunday

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* 9. Frequency of volunteer availability 

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