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Survey page

This survey is to gather information that will help leaders and emergency preparedness coordinaters in your area become better prepared to help out in an emergency.

Simply fill out the fields in the form below and click submit. 

None of the fields in the form are mandatory, they are just there to help us gather emergency information.

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Results from the survey will be kept confidential and will not be shared with anyone who does not need them.

Liberty 1st Ward Emergency Preparedness Survey
Are you interested in becoming a block captain?
Does any member of the family work outside of the valley? This is to find ways to reunite the family in the event of an emergency.
Are there any special needs or elderly family members that would need to be taken into consideration in the event of an emergency? Does this apply to any of your neighbors?
Do you have any experience with GMRS or Ham Radios?
Would you like help with starting or reenergizing your food storage and/or emergency preparedness?
Do you have any of the following on hand to assist your family or neighbors in the event of an emergency? pumps, generators, heavy equipment (backhoes, dump trailers, skidsteer, etc)
Do you or your members of your immediate family have any of the following skills and would be willing to offer them in the event of an emergency: medical/dental (doctor, nurse, dentist, PA, etc), electrical, plumbing, HVAC, construction, heavy equipment operation

Thank you for filling out the survey

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