On behalf of Governor Roy Cooper, the NC Commission on Volunteerism and Community Service and the NC Emergency Management Human Services Branch Manager would greatly appreciate your help in documenting your organization’s volunteer activities in the NC response to disasters across the state. This information will help us identify gaps in service and also recognize your efforts. Please respond once a week, preferably every Thursday.

Question Title

* 1. Contact Information

Question Title

* 2. On what North Carolina disaster are you reporting for this time period?

(Please report volunteer hours for one disaster at a time. You may need to complete the survey multiple times.)

Question Title

* 3. What counties does your organization serve?

  County
1
2
3
4
5

Question Title

* 4. How would you categorize your disaster response activities?

  Category
1
2
3

Question Title

* 5. Please share specific activities your organization is performing.

Question Title

* 6. What quantities of the above have you provided? Totals, totals per day/week.

Question Title

* 7. What other organizations are you coordinating with in disaster response activities?

Question Title

* 8. Please provide the number of volunteers and total number of volunteer hours relating to this disaster.

Question Title

* 9. Please specify the time period for the number of volunteers and total volunteer hours from the previous question.

Date
Date

Question Title

* 10. Please document any details about multiple activities or locations for those volunteers.

Question Title

* 11. Do any of the volunteer hours reported above correspond to public assistance projects (ex. moving fallen trees, mass feeding, sheltering)? If so, please give details on specific projects and hours.

Question Title

* 12. Please attach any available situation reports containing relevant volunteer activity.

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.
Choose File

Question Title

* 13. What populations are you serving?

Question Title

* 14. Do you have a system in place to ensure people do not receive more than their allotment?

Question Title

* 15. Is your organization willing to expand services if provided additional resources?

Question Title

* 16. Do you have any disaster response related essential needs you are unable to obtain through normal or local channels?

Question Title

* 17. By what date do you hope to fulfill this need?

Date

T