

A Service of the members of the Port Washington-Manhasset Office of Emergency Management
THIS APPLICATION IS AVAILABLE HERE FOR FILLING OUT ONLINE
If you are interested in applying for a volunteer position at the Port Washington Point of Dispensing (POD) or in general with the PWMOEM, please fax this application back to (516) 717-0001. You may also email us at info@pwoem.org.
POD training is expected to be once a year; although probably additionally during start-up phase. You would be expected to help staff the POD if Nassau County were to declare a health emergency. In addition to medical skills, there are many other skills that are needed. General volunteers for the PWMOEM are desired as well.
Name: ________________________
Address: ________________________
Village: _________________________
Home Phone: ________________________
Cell Phone: ________________________
Work Phone: ________________________
Email: ________________________
Occupation/work training: ________________________
In which County/Boro do you work? (circle one):
Nassau, Suffolk, Queens, Brooklyn, Manhattan, Bronx, Westchester, NJ, Other
Besides English, what languages do you speak fairly fluently? ___________
What medical training, if any, do you have? _________________________
_____________________________________________________________
What security background, if any, do you have? ______________________
Other skills that you wish to make us aware of? ______________________
____________________________________________________________
Please fax this application back to (516) 717-0001 or email us at info@pwoem.org