Training Pre-Registration Is this your first time attending orientation?(Required) Yes No Are you an active member of a Southern Baptist Church or Baptist Collegiate Ministries, and at least age 18?(Required) Yes No Disaster Relief training and certification is intended for individuals over 18 years of age and an active member of a Southern Baptist Church. If you do not meet these criteria, you are welcome to attend but you will not receive a cap or badge.Contact InformationLegal Name(Required) First Last Preferred Name Email Address(Required) Enter Email Confirm Email Cell Phone(Required)Returning Volunteer InformationIs your current badge expired or will it expire within the calendar year?(Required) Yes No Disaster Relief Badge Expiration Date(Required) MM slash DD slash YYYY If you do not have a badge please select "Yes" to the question about being your first time above and fill out all the form fields.Volunteer InformationGender(Required) Male Female Date of Birth(Required)Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Address(Required) Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Secondary PhoneWork PhoneZone(Required) Central NE NW SE SW Central is Cleveland, McClain & Oklahoma Counties. I-35 & I-40 mark NE, NW, SE, SW.Church/BCM Name(Required) Church/BCM City(Required) AssociationArbuckleAtoka-CoalBannerBeckham-MillsBryanCaddoCentralCherokee StripCherokeeChi-Ka-ShaChoctaw-ChickasawCimarronComanche-CottonCraig-MayesEast CentralEnonFriscoGradyGreat PlainsJohnston-MarshallKayLeFloreMetro Baptist Network (Formerly Capital)MullinsMuscogee-Seminole-WitchitaMuskogeeNorth CanadianNortheasternNorthwesternPanhandlePittsburgPottawatomie-LincolnRogersSalt ForkSans BoisSouth CanadianTulsa MetroUnionWashington-OsageWestern OklahomaNot SureOtherBeneficiary's Name(Required) Beneficiary's NumberEmergency Contact's Name Emergency Contact's NumberWhat would you like to be trained in today?(Required) Feeding Chainsaw Recovery (MudOut) Shower/Laundry What would you like to be trained in today?(Required) Feeding Chainsaw Recovery (MudOut) Shower/Laundry Chaplaincy FormStack Initial Contact Assessment (pre-requisite of Chainsaw & Recovery plus experience) First Aid (only available on October training session) None Additional InformationPlease select orientation date and location you are attending(Required)Chaplain RenewalOctober 14, 2023, Disaster Relief Team CenterLanguages Spoken(Required) English Spanish Chinese (Mandarin) French Vietnamese Russian German Other Other Languages(Required) PaymentRegistration Type New Volunteer ($30) Returning Volunteer - Badge Renewal ($20) Returning Volunteer - Badge Current ($0) BCM Student ($20) Alternate Payment Option Cash Check Credit CardCard Details Cardholder Name Upon submission of this form you will be automatically redirected to a background check application form which you will need to complete prior to attending training. We will not process the background check until you have completed training.
