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The Infragard Minnesota Membership Alliance is working to create protocols and procedures to coordinate emergency response activities with Minnesota Homeland Security and Emergency Management. For this effort to be effective, we need your help, take a few minutes to tell us more about you and let us what you need from it.
Note - individual results will remain private and not be released.
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Your Sector - Choose the one that best represents the primary business of your company.
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Your Profession - Describe your profession or role within your company.
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Your Response Role within Your Company - Please describe your emergency response role within your company. Key here is your role in response, not every day. If you can be a single point of contact, accessing all company decisions and resources as necessary, select "Key Contact".
| Key Contact-make/facilitate decisions/resources |
| Functional Contact-Response role, no decisions |
| Planner-Planning, not response role |
| Non-Responder-Interested, not planner/responder |
| Other, please specify |
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Your Experience/Training for Emergency Operations Center (EOC) Role - In order to determine our ability to interact operationally with emergency management activities, we need to understand the experience and availability of members. This question addresses experience and training.
| Have Worked in EOC Evironment - Qualifications current |
| Experience in Corporate Crisis Management or EOC Environment |
| Currently First Responder - EMS, Police, Fire, etc. |
| Completed FEMA - IS-700 NIMS: An Introduction |
| Completed FEMA - IS-800 NRP: An Introduction |
| Completed FEMA - ICS-100 Introduction to ICS |
| Completed FEMA - ICS-200 Basic ICS |
| Community Emergency Response Team (CERT) |
| First Aid Certification |
| CPR Certification |
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Special Skills List any additional special skills that may be useful during an emergency.
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Your availability to act in a response role during emergency?
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Your concerns - Please check the following potential emergency response-related Infragard activities that are important to you.
| Response coordination (i.e. working with State Emergency Operations Center) |
| Pandemic preparedness |
| Terrorism threat |
| Public and private response coordination |
| An exercise (such as Operation Reality Check) |
| 2008 Republican Convention |
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Your Emergency Contact Info
Required to participate in Public/Private Community Action Team and receive emergency communications from State Emergency Operations.
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What is your availability to work on planning projects?
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Additional comments - Topics you would like to hear about, additional comments on questions above, etc.
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To apply for secure Infragard Membership:
STEP #1 – Review the ByLawsof the InfraGard Program
STEP #2– Click on the link below and follow the instructions for the Membership Application
http://www.infragard.net/membership/
STEP #3– Mail your ORIGINAL , COMPLETED Application to:
InfraGard Program Coordinator
Suite 1100
111 Washington Avenue, South
Minneapolis, Minnesota 55401-2176
(612) 376-3200
Questions?
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