sponsored by 
HOME | OUR WORK | ABOUT US | CONTACT US



Disaster Response Volunteer Database
Powered by Truist

Thank you for your interest in volunteering.

You must be 18 years of age or older to register.

In times of crisis, volunteers are one of our most important resources.  Volunteers help rebuild communities after a disaster and help individuals and families affected by disaster to get back on their feet.

By taking time to pre-register to assist during a disaster, you are making a difference.

Depending on your geographic preference and availability, the information that you provide here will be shared with the appropriate emergency planning coordinator in Portsmouth, Southern Strafford County and Northern Strafford County.

It is the responsibility of the emergency planning coordinator to follow up with each volunteer to verify information and provide training, as needed.

Email account users:  Once you have registered, you will receive occasional announcements and updates regarding disaster planning, upcoming trainings and events.

*Please note that you cannot save your answers and exit the registration form before completion.  In addition, you will not be able to go back and change information on your registration once it is submitted.

1. Your first name *
2. Your last name *
3. Your email address *
4. Your local phone number (with area code)
5. * Local phone number (with area code)
6. Daytime phone number (if different than local phone #)
7. Cell phone number
8. * Street Address
9. * City
10. * State
11. * Zip code
12. * Date of birth
   
13. * Emergency Contact (name, relationship and phone)
14. * Area/county where you are able to respond
15. * Have you received prior approval from your employer to volunteer in the event of a disaster?
16. If you are a healthcare professional, have you registered with the Emergency System for the Advance Registration of Volunteer Healthcare Professionals (ESAR-VHP)?
17. * What skills, licenses and/or certifications do you have? Check all that apply
18. If you selected 'other', please describe here.
19. If applicable, please indicate if you are fluent (able to communicate effectively) in another language.
20. If you selected 'other," please describe here.

Liability disclaimer:

The NH Good Samaritan Law provides that any person in good faith who renders emergency care is exempt from civil liability as long as he acts exclusive of compensation and reasonably provides emergency care without willful or wanton acts of negligence.

House Bill 618 further extends the scope of the registered volunteer by offering worker's compensation when performing volunteer duties during a state emergency.

21. * Are you covered by medical insurance?
22. * Do you have any physical restrictions? (i.e. no heavy lifting, specific allergies etc.)
23. If 'yes,' please describe briefly
24. * Are you willing to undergo a background check?
25. * Have you ever been convicted of a felony?

 

 

Contact United Way of the Greater Seacoast
The inclusion of any organization or person in this database does not constitute a representation, warranty, or endorsement with respect to the competence, suitability, or reliability of such organization or person by United Way of the Greater Seacoast; nor does United Way of the Greater Seacoast sponsor or endorse any third-party web site. Legal Notices