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Massachusetts Service Alliance - Register

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Any information you enter below will not be given or sold to anyone without your permission. Submitting this form does not bind you to anything! All fields marked with a * must be filled in.

Please note, if you are registering to volunteer in a disaster you must opt in to receive emails from us. We are currently looking for volunteers who have skills in the areas marked by an (*).

Account information
* Username
* First name
* Last name
* Email
		We use an opt-in email system - you will only receive email from us when you specifically ask us to send it to you.
Password
* Password
* Verify Password
Disaster Relief Information (required for those interested in Disaster Relief)
* Would you like to volunteer in the event of an emergency?		Yes No
What phone number (including area code) can we reach you at quickly in the event of a disaster?
Please check your skills related to disaster relief		Account/Financial Planners Administrative Support Amateur Radio Operator Animal Handler (SMART) Bus Driver Carpentry CERT Trained * Child Care Provider * Civil Engineering * Cleaning Services * Communications Systems Repair * Computer Technician Construction Operator Cook/Food Service Worker * Crisis Counseling * Data Entry Database Administrator Debris Hauling * Doctor Elder Care Provider Electrician EMT Fire Fighting First Aid/CPR Certified Fork Lift Operations Heavy Equipment Operations Heavy Lifting/Rigger HVAC Repair Hydraulics Insurance Adjuster/Consultant * Infrastructure Repair (Bridges, Roads, etc) * Laborer * Lawyer * Network Administrator Nurse Paving Plumber Public Relations Relocation services Roofer Sanitarian * Security services Social/Case Management services * Snow Plow Operators Teachers Telephone operator Tow Truck Operators Translator * Tree Removal Truck Drivers * Veterinarian Warehouse Operations *
Describe any equipment you could and would bring to assist in the event of a disaster
Do you speak any of the following languages fluently?		Spanish Portugese French Polish Italian German Greek Russian Arabic Hebrew Hindi Cantonese Mandarin Korean Japanese Sign Language
If travel to site necessary, how many hours will you need to prepare for travel		Less than 1 Hour Between 1 and 3 Hours Greater than 3 Hours
Are you able to pay your own travel expenses?		Yes    No
As a medical professional, are you interested in registering in the Mass System Advance Registration (MSAR)?		Yes    No
Contact information
Phone (including area code)
Street Address
City
State		Choose a State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Postal Code
Preferences
* Want to receive current events in your area, community spotlights on local organizations, and general news by email?		Yes      No
By continuing, you agree to these legal notices.

 

 

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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 Massachusetts Service Alliance; nor does Massachusetts Service Alliance sponsor or endorse any third-party web site. Legal Notices