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Volunteers, Services, Facilities, and/or Equipment Support Registration

In the days, weeks, and months following a disaster, community members look for opportunities to help with recovery. This effort provides a centralized volunteer resource for when a need for support arises and ensures volunteers are ready to serve, directing volunteers during the crisis, supporting recovery efforts, and reporting volunteer impact.

Organization Type: ^*

Organization Name: ^*

Street Address: ^*

City: ^*

Zip Code: ^*

Primary Contact First Name: ^*

Primary Contact Last Name: ^*

Primary Contact Email: ^*

Primary Contact Phone: ^*

Secondary Contact Name/Email/Phone:

__________________________________________

Volunteer Information

Please share your volunteer numbers, recruitment needs, and skills.

How many volunteers can your organization provide for small to large-scale incidents? ^*

Do you need to recruit additional volunteers to support your organization's relief efforts? ^*

Note(s):

Our organization can provide volunteers to help with the following:

Debris removal

General response (indoor and/or outdoor work supporting as needed)

Ongoing cleanup and restoration

Mitigation (for example, sandbagging)

Security/public safety

Medical services/professionals (CPR/first aid, physicians, nurses, CNAs, paramedics, EMTs, etc.)

Emotional and spiritual care

Crisis counseling

Short-term case management

Temporary shelter management

Childcare

Disaster preparedness

Other/note(s):

__________________________________________

Services and Resources

Please share services and resources your organization can provide for disaster relief.

Our organization can provide these services and resources:

Donation logistics (storage, distribution, and/or management)

Transportation services for food or other goods

Transportation for the elderly and/or persons with disabilities or medical conditions

Childcare program or facility

Care for people with disabilities

Veterinarian, shelter, or animal care services

Relief supplies

Packaged foods

Bottled water

Prepared meals/mass care feeding

Other/note(s):

__________________________________________

Facility(-ies) and Equipment

Please share details about your facility (-ies) and/or equipment that could aid disaster relief.

Our organization's facility(-ies) can provide:

Cooling or warming station

Meeting or staging space

Storage

Commercial kitchen

Temporary shelter

Other/note(s):

If your facility has space to be used for meetings, staging, storage, and/or temporary shelter during a small to large-scale incident, what is the size (square footage) and type of space that is available?

If you can provide space for temporary shelter, do you have access to cots, etc.? Are non-service animals permitted in or around the shelter space?

Is your facility equipped with a generator?

Our organization can provide the following equipment:

List any equipment your organization has available to support response and recovery from a disaster or emergency.

__________________________________________

Intent to Participate in Activate for Disasters

As a participant in the Heart of Illinois United Way’s Activate for Disasters initiative, we maintain autonomy and control of our voluntary resources in the event of a disaster unless a secondary, direct agreement is established. Organizational membership in the Activate for Disasters initiative is open to organizations that agree to collaborate and be a part of the initiative. Emergency management agencies (EMA) will assess the needs of residents following an incident to determine what volunteers, services, facilities, and equipment will be needed related to response and/or recovery. Currently, the Peoria City/County Health Department EMA partners with the Heart of Illinois United Way to coordinate volunteer needs in the event of a disaster or community-wide emergency.

Our organization voluntarily agrees to participate in the Heart of Illinois United Way’s Activate for Disasters initiative. ^*

By registering to participate in the Activate for Disasters initiative, your organization's primary and secondary contact will receive regular email communications from volunteer.hoiunitedway.org. If you have questions, or need to update your organization's contact information, email gina.edwards@local.unitedway.org

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