Community and Volunteer Group Interest Survey

Please provide the information for the persons within your organization that will be the primary and alternate points of contact to receive information from Lincoln County regarding the Echo Mountain Fire long term recovery group, new COAD and/or VOAD. You must fill out the form for each individual and can fill out the form multiple times per organization.

Organization Name

Is your agency a nonprofit?

Yes

Does your organization have paid staff or volunteer?

Paid Staff

Volunteers

Both

Point of Contact Information

First Name

Last Name

Email Address

Phone Number

Are you the primary or alternate point of contact?

Primary Point of Contact

Alternate Point of Contact

*Is your organization interested in assisting with the Echo Mountain Fire Complex Long Term Recovery Group?

This group supports affected individuals and their families. *The specifics of assistance will be discussed further at the introductory meeting.

Yes

Maybe

If your organization interested in being a part of the Lincoln County COAD or VOAD Groups?

VOAD Group - Voluntary Organizations Active in Disaster A consortium of recognized volunteer groups who work within a defined area (local, county, regional, etc.) in all phases of an emergency-generally in concert with a local Emergency Operations Plan. COAD Group - Community Organizations Active in Disaster Generally the same purpose as a VOAD but may have more localized partners and are more comfortable utilizing the word Community

COAD

VOAD

Both

Would you like to receive information directly from County Emergency Management or Public Health Emergency Preparedness?

Please select all those you wish to recieve.

Select or enter value

Send me a copy of my responses

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