Good Neighbor Ministry: Skills Survey

Thank you for visiting our website. So that we may get a better idea of your skills and areas where you'd like to assist, please fill out the information in the form below. When finished, click on the "Submit" button. Be sure to include your address, e-mail, or phone so that someone can follow up with you.


Name:     

E-mail:    

Phone:    

Address:



SKILLS/INTEREST(Indicate how you can help during crisis or disaster. Check all that apply):
Animal Care
Architect/Engineer
Carpentry
Citizens Band Radio
Concrete & Masonry
Counsellor
CPR/First Aid
Doctor
Drywall
Electrical
Flooring
Foreign Language(s)
Nurse
Pharmacist
Phone calls (phone tree)
Plumbing

HUMAN SERVICES(services you'd be willing to provide):
Baby sitting to assist with children while parents are coping with crisis
Contacting relatives of persons disoriented and in shock
Food Preparation for work teams and/or disaster victims
Household cleaning or shopping
Laundry service for stricken or stranded victims
Personal items such as soap, towels, tooth brushes
Respite care to provide a temporary break for a care giver
Temporary housing for disaster victims
Transportation to medical clinics or other short trips for disabled or stranded

EQUIPMENT(which you can provide for temporary use):
4 Wheel Drive
Blankets & Bedding
Camper for temporary housing
Cot
Generator
RV which could be used for temporary housing
Tent
Trailer
Truck

Please add any additional comments or questions in the box below: