POTTAWATTAMIE COUNTY EMERGENCY MANAGEMENT AGENCY

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1 POTTAWATTAMIE COUNTY EMERGENCY MANAGEMENT AGENCY 227 S. 6 TH ST, SUITE 23B, COUNCIL BLUFFS, IA (712) POTT.EMA@POTTCOUNTY.COM VOLUNTEER APPLICATION The Pottawattamie County Emergency Management Agency Volunteers assist in preparedness, response, recovery and mitigation activities under the supervision of the Pottawattamie County Emergency Management Agency. Your willingness to serve the needs of Pottawattamie County citizens is greatly appreciated. Pottawattamie County Emergency Management Commission is an Equal Employment Opportunity employer. MISSION STATEMENT To establish sustainable communities and ensure economic opportunities for the communities and citizens of Pottawattamie County through comprehensive emergency management. VOLUNTEER GUIDELINES o Volunteers must be at least 18 years of age. o Volunteers will be required to attend an orientation and training program commensurate with their assigned scope of work. o Volunteers must be a CERT graduate or affiliated with an independent private non-profit/non-governmental organization. Unaffiliated volunteers may be accepted at the discretion of the EMA Director based on special skills or experience. o All identified training certificates; licensure and a valid copy of your driver license must be submitted with this application. o Volunteers will be required to pass a criminal background check. VOLUNTEER REQUIRED INFORMATION Last Name First Name Address City State Zip Home Phone Occupation Cell Phone Emergency Contact Phone Date of Birth Why are you interested in becoming a volunteer? Are you a CERT Basic Course graduate? YES NO Course completion certificate required. Are you a licensed Pott County ARES Member? YES NO Call Sign Copy of license required. Are you RACES certified/approved? YES NO Certificate required. AREAS of VOLUNTEER INTEREST CERT BASIC INSTRUCTOR EOC COMMUNICATIONS EOC WEATHER COMMUNITY OUTREACH & EDUCATION EOC SUPPORT STAFF ANIMAL SUPPORT OPERATIONS VOLUNTEER MANAGEMENT PUBLIC SERVICE EVENTS Activity descriptions on the following page.

2 CERT INSTRUCTOR: Member will assist in the delivery of CERT Basic courses, exercises and continuing education for community members and CERT Volunteers. Leadership Team monitoring, evaluation and completion of the CERT Train-the-Trainer course may be required. EOC COMMUNICATIONS: Member will be amateur radio qualified or have previous radio communications experience. Member will provide communications support in the Emergency Operations Center for a variety of activations (weather events, special events, disaster support, nuclear power plant emergencies or exercises). Members may also be deployed to specific field locations during events to assist in the effective delivery of communications. EOC WEATHER: Member will staff a variety of EOC positions in support of severe weather operations with a focus on situational awareness, data collection and field storm spotter safety. Activities may include radar monitoring, media monitoring, answering EOC phones, providing situation updates to partners, receiving and relaying damage and storm reports. COMMUNITY OUTREACH & EDUCATION: Member will provide outreach seminars or educational presentations to community members and organizations as part of the Emergency Management Agency preparedness strategy. Events could range from volunteer recruiting, CERT program overview, general emergency preparedness, severe weather awareness or other topics relating to the risks and hazards to communities within Pottawattamie County. EOC SUPPORT STAFF: Similar to EOC Weather, member will staff a variety of EOC support positions during actual emergencies or events that include, but are not limited to: situational awareness activities, answering EOC phones, clerical support, logistics support, public information support, liaison duties. ANIMAL SUPPORT OPERATIONS: Member will support operations related to animals affected in disaster. This is a joint undertaking with the Pottawattamie County Animal Control Animal Rescue Team. Primary focus will be the establishment and management of a disaster animal shelter to support rescue operations and shelter operations of affected citizens. VOLUNTEER MANAGEMENT: Member will support disaster response and recovery missions requiring the use of affiliated and unaffiliated volunteers to respond to community needs. Member will be responsible for the operational supervision of assigned volunteers at disaster locations. Member will be required to work in disaster areas which could pose an increased safety risk based on the event or in environmental conditions such as heat, rain, snow, flooded areas, etc. PUBLIC SERVICE EVENTS: Member will support community events throughout the county with non-typical work assignments such as, but not limited to: accountability, parking, traffic control, public information/event support. Have you ever been arrested for or convicted of a crime, excluding minor traffic offenses? NO YES (Provide details below) Note An arrest or conviction will not necessarily disqualify you for volunteer activities. The circumstances of the conviction will be considered based upon the nature and duties of the requested volunteer activities. LIABILITY RELEASE & WAIVER I understand that my relationship with the Pottawattamie County Emergency Management Agency and the Pottawattamie County Emergency Management Commission is that of a volunteer. I understand that there are certain risks associated with these volunteer activities related to emergency and disaster preparedness and response which could include physical injury or illness. I hereby waive, release and forever hold harmless the Pottawattamie County Emergency Management Commission, its officers, employees or agents from any and all claims arising from my volunteer activities with the Pottawattamie County Emergency Management Agency. Printed Name Date Signature Mail or bring this application, along with the completed background check release form, volunteer coverage application, copies of identified certificates/licensure and a copy of your driver s license, to: Pottawattamie County Emergency Management Agency 227 South Sixth Street, Suite 23B Council Bluffs, Iowa 51501

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