We appreciate your willingness to assist in times of an emergency/major disaster.  This form will add your information to AmericaView's Emergency Response database and the data you provide will allow us to quickly and accurately identify those who possess specific expertise for the benefit of those affected in times of emergency.

Thank you for your time.

First Name
Last Name
Title
Organization Name
Email Address
Work Phone
Cell Phone
Home Phone
State
Will you assist:

 
  • With a major disaster in your state?

  • With a disaster involving major
    loss or risk to life in your state?
  • If the International Charter is invoked in your state?
  • With a major disaster outside of your state?
  • With a disaster involving major
    loss or risk to life outside your state?
  • If the International Charter is invoked outside your state?
What time zone do you live in?
Please indicate your areas of expertise in
data analysis and image processing:
(use the ctrl key to select multiple values)
Please indicate the sensors or platforms
whose data you have worked with:
(Use the ctrl key to select multiple values from the list)

In addition to the previous question, please
indicate sensors or platforms whose raw data
(level 0) that you have processed:
(use the ctrl key to select multiple values)

For the following days/times, select Yes or No to verify the times you
would be willing to assist with emergency response.

 
Monday 8 a.m. to 5 p.m.
Monday 5 p.m. to 9 p.m.
All other hours on Monday
Tuesday 8 a.m. to 5 p.m.
Tuesday 5 p.m. to 9 p.m.
All other hours on Tuesday
Wednesday 8 a.m. to 5 p.m.
Wednesday 5 p.m. to 9 p.m.
All other hours on Wednesday
Thursday 8 a.m. to 5 p.m.
Thursday 5 p.m. to 9 p.m.
All other hours on Thursday
Friday 8 a.m. to 5 p.m.
Friday 5 p.m. to 9 p.m.
All other hours on Friday
Saturday 8 a.m. to 5 p.m.
Saturday 5 p.m. to 9 p.m.
All other hours on Saturday
Sunday 8 a.m. to 5 p.m.
Sunday 5 p.m. to 9 p.m.
All other hours on Sunday
List any Homeland Security Infrastructure Program (HSIP)
Freedom or other standard vector layers for map
generation to which you have access to:

Are there other datasets, imagery, vector data
or sensors that your organization maintains
that could be made available for emergency response?

How could your organization best assist
in an emergency event?
(use the ctrl key to select multiple values)

Are there specific datasets that would benefit
your organization's response efforts?

What value-added products could you assist
in creating during an emergency event?
List any resources you have for archiving and
distributing digital data during an emergency event:
Please indicate the operating systems
that you work with:
(use the ctrl key to select multiple values)
Out of the operating systems you selected in
the previous question, which one is the primary
operating system that you use?
Please indicate which software programs
with which you commonly use:
(use the ctrl key to select multiple values)
Are you willing to allow other emergency
responders to utilize your lab or facilities
in an emergency event?
Do you require compensation in order to assist?
Please list names and email addresses of individuals,
including those within your organization, that you
would recommend for this questionnaire:
Is there any additional information you would like to provide?
          
First Name {FIRSTNAME}{ID}
Last Name {LASTNAME}
Title {TITLE}
Organization Name {ORGANIZATIONNAME}
Email Address {EMAIL}
Work Phone {WORKPHONE}
Cell Phone {CELLPHONE}
Home Phone {HOMEPHONE}
State {STATE}
Will you assist: {_UNBOUND_STATICTEXT_3}
  • With a major disaster in your state?
 {ASSISTANYMAJORINSTATE}

  • With a disaster involving major
    loss or risk to life in your state?

 {ASSISTMAJORLOSSINSTATE}
  • If the International Charter is invoked in your state?
 {ASSISTWHENICINVOKEDINSTATE}
  • With a major disaster outside of your state?
 {ASSISTANYMAJOROUTSIDESTATE}
  • With a disaster involving major
    loss or risk to life outside your state?
 {ASSISTMAJORLOSSOUTSIDESTATE}
  • If the International Charter is invoked outside your state?
 {ASSISTWHENICINVOKEDOUTSIDESTATE}
What time zone do you live in? {TIMEZONE}
Please indicate your areas of expertise in
data analysis and image processing:
(use the ctrl key to select multiple values)		 {AREASOFEXPERTISE}
Please indicate the sensors or platforms
whose data you have worked with:
(Use the ctrl key to select multiple values from the list)		 {SENSORS}

In addition to the previous question, please
indicate sensors or platforms whose raw data
(level 0) that you have processed:
(use the ctrl key to select multiple values)

 {SENSORSLEVEL0}

For the following days/times, select Yes or No to verify the times you
would be willing to assist with emergency response.

{_UNBOUND_STATICTEXT_2}
Monday 8 a.m. to 5 p.m. {TIMEMON8TO5}
Monday 5 p.m. to 9 p.m. {TIMEMON6TO9}
All other hours on Monday {TIMEMON24}
Tuesday 8 a.m. to 5 p.m. {TIMETUE8TO5}
Tuesday 5 p.m. to 9 p.m. {TIMETUE6TO9}
All other hours on Tuesday {TIMETUE24}
Wednesday 8 a.m. to 5 p.m. {TIMEWED8TO5}
Wednesday 5 p.m. to 9 p.m. {TIMEWED6TO9}
All other hours on Wednesday {TIMEWED24}
Thursday 8 a.m. to 5 p.m. {TIMETHU8TO5}
Thursday 5 p.m. to 9 p.m. {TIMETHU6TO9}
All other hours on Thursday {TIMETHU24}
Friday 8 a.m. to 5 p.m. {TIMEFRI8TO5}
Friday 5 p.m. to 9 p.m. {TIMEFRI6TO9}
All other hours on Friday {TIMEFRI24}
Saturday 8 a.m. to 5 p.m. {TIMESAT8TO5}
Saturday 5 p.m. to 9 p.m. {TIMESAT6TO9}
All other hours on Saturday {TIMESAT24}
Sunday 8 a.m. to 5 p.m. {TIMESUN8TO5}
Sunday 5 p.m. to 9 p.m. {TIMESUN6TO9}
All other hours on Sunday {TIMESUN24}
List any Homeland Security Infrastructure Program (HSIP)
Freedom or other standard vector layers for map
generation to which you have access to:		 {ACCESSTOHSIP}

Are there other datasets, imagery, vector data
or sensors that your organization maintains
that could be made available for emergency response?

 {DETAILOFORGANIZATIONMANAGEDRESOURCE}

How could your organization best assist
in an emergency event?
(use the ctrl key to select multiple values)

 {HOWCOULDORGASSIST}

Are there specific datasets that would benefit
your organization's response efforts?

 {DETAILOFDATASETNEEDEDFORDR}

What value-added products could you assist
in creating during an emergency event?

 {DETAILOFASSISTINGVALUEADDEDPRODUCT}
List any resources you have for archiving and
distributing digital data during an emergency event:		 {DETAILOFRESOURCEFORDIGITALDATAARCHIVE}
Please indicate the operating systems
that you work with:
(use the ctrl key to select multiple values)		 {OS}
Out of the operating systems you selected in
the previous question, which one is the primary
operating system that you use?		 {PRIMARYOS}
Please indicate which software programs
with which you commonly use:
(use the ctrl key to select multiple values)		 {SOFTWARE}
Are you willing to allow other emergency
responders to utilize your lab or facilities
in an emergency event?		 {FACILITYOPENING}
Do you require compensation in order to assist? {COMPENSATIONREQUIRED}
Please list names and email addresses of individuals,
including those within your organization, that you
would recommend for this questionnaire:		 {MORETOCONTACT}
Is there any additional information you would like to provide? {ADDITIONALINFO}