Member-Partner Information

TGCRVOAD Member/Partner Information

Reason For Submission(Required)

ABOUT YOUR ORGANIZATION

Please tell us about your organization.

Organization Name(Required)

Department or Branch (if applicable)

Organization's Direct Phone Number(Required)

Physical Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Mailing Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Social Media

Website

Facebook

Instagram

Twitter

Your logo(Required)

Max. file size: 100 MB.

Hi-resolution please

Type of Membership(Required)

Member

Member, prospective

Partner

Partner, prospective

Organization Type(Required)

Nonprofit Corporation with 501(c)3

Nonprofit Corporation

Nonprofit Association

For profit or commercial corporation

Government

Member Since

Year of initial membership or partnership (if known)

Affiliation(s)

Other Affiliation(s)

Please list other relevant affiliations

ROLES IN A DISASTER

TGCRVOAD helps our members and partners communicate, coordinate, cooperate, and collaborate during a disaster response. To accomplish our goal it is important to know what your organization does during a disaster.

Mission(Required)

a short description of what your organization does.

What Phases of a disaster is the organization active in?(Required)

Mitigation

Preparedness

Relief / Response

Recovery – Long Term

Recovery – Short Term

check all that apply

Counties Served(Required)

Disaster Activities(Required)

Other Disaster Activities

CORE Disaster Activities(Required)

Other CORE Disaster Activities

The two, three, or four things you do really well.

Disaster Experience(Required)

Briefly share your organizations disaster experience

Non-Disaster Services(Required)

FREE FORM TEXT

Every Member and Partner has space on its directory page to provide any additional information it would like to share with other VOAD organizations.

Free Form Text

include anything you would want to share with other COAD members about your organization

MOBILIZATION

We’d like to know how quickly your organization can respond to a disaster. Please include information that you want to make the VOAD leadership aware of.

Mobilization Timeframe(Required)

Less than 4 hours

5-11 hours

12-24 hours

25-47 hours

48+ hours

Mobilization Notes

COMMITTEE/WORKGROUP PREFERENCE

Every Member or Partner is expected to serve on at least one Committee/Workgroup. Please indicate which committees your organization has an interest in serving on.

Committees and Workgroups(Required)

Communication

Education and Training

Individual, Family and Community Resources

Membership & Engagement

Operational Coordination

CONTACTS

Please provide at least one and up to five contacts for your organization. The first contact I the primary voting representative for your organization. The second is their alternate.

Primary Contact (Voting)

Name(Required)

First Last

Title(Required)

Email(Required)

Direct Phone(Required)

Mobile Phone(Required)

Contact 2 (Alternate Voting Contact)

Name

First Last

Title

Direct Phone

Mobile Phone

Contact 3

Name

First Last

Title

Direct Phone

Mobile Phone

Contact 4

Name

First Last

Title

Direct Phone

Mobile Phone

Contact 5

Name

First Last

Title

Direct Phone

Mobile Phone

REVIEWED BY

Please provide the name of the organizational representative who reviewed this directory listing for accuracy and completeness and the date the check was performed.

Name(Required)

Date(Required)