Emergency Job Matching Signup

Tell us about yourself

Please take a few minutes to answer the questionnaire below. The information will be used to identify persons with specific skill sets in order to assign individuals to emergency response efforts in times of disaster.

You may update your information at any time by completing this form again.

This information may also be shared with other local agencies during an emergency.

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Name

First Name *

Last Name *

Employment

Your Employer *

County of Shasta Employee

City of Anderson Employee

City of Redding Employee

City of Shasta Lake Employee

Other Public Sector Employee

Private Sector Volunteer

Employer Name *

Please specify

Job Title *

Employee ID *

DSW Organization Name

If you are currently a Disaster Services Worker (DSW), please provide the Organization Name.

Email Addresses (Provide one or more email addresses)

Work Email

Personal Email *

Phone Numbers (Provide one or more phone numbers)

Work Phone

Home Phone

Cell Phone *

Professional Certifications and Licenses (Provide your professional certification/license numbers)

Accounting (CPA)

Certified Nursing Assistant (CNA)

CORE

Counseling (MFT, LCSW, etc.)

EMT

Medicine (DO, MD)

Nurse Practitioner

Nursing RN

Nursing LVN

Paramedic

PharmD

Pharmacy Technician

Phlebotomy

Physical Therapy

Physician Assistant (PA)

POST

PsyD

Additional certification/license

Skills (Please indicate your experience level with the following skills)

Skill	N/A	1-3 Years	4-8 Years	9+ Years
Audio/Visual (AV) Equipment	Audio/Visual (AV) Equipment - N/A	Audio/Visual (AV) Equipment - 1-3 Years	Audio/Visual (AV) Equipment - 4-8 Years	Audio/Visual (AV) Equipment - 9+ Years
Animal Control/Animal Services	Animal Control/Animal Services - N/A	Animal Control/Animal Services - 1-3 Years	Animal Control/Animal Services - 4-8 Years	Animal Control/Animal Services - 9+ Years
Call Center	Call Center - N/A	Call Center - 1-3 Years	Call Center - 4-8 Years	Call Center - 9+ Years
Case Management	Case Management - N/A	Case Management - 1-3 Years	Case Management - 4-8 Years	Case Management - 9+ Years
Clerical	Clerical - N/A	Clerical - 1-3 Years	Clerical - 4-8 Years	Clerical - 9+ Years
Communications (document preparation/editing)	Communications (document preparation/editing) - N/A	Communications (document preparation/editing) - 1-3 Years	Communications (document preparation/editing) - 4-8 Years	Communications (document preparation/editing) - 9+ Years
Conflict Resolution	Conflict Resolution - N/A	Conflict Resolution - 1-3 Years	Conflict Resolution - 4-8 Years	Conflict Resolution - 9+ Years
Contract/Agreement Experience	Contract/Agreement Experience - N/A	Contract/Agreement Experience - 1-3 Years	Contract/Agreement Experience - 4-8 Years	Contract/Agreement Experience - 9+ Years
Correctional Officer	Correctional Officer - N/A	Correctional Officer - 1-3 Years	Correctional Officer - 4-8 Years	Correctional Officer - 9+ Years
Counseling/Therapy	Counseling/Therapy - N/A	Counseling/Therapy - 1-3 Years	Counseling/Therapy - 4-8 Years	Counseling/Therapy - 9+ Years
Custodian	Custodian - N/A	Custodian - 1-3 Years	Custodian - 4-8 Years	Custodian - 9+ Years
Customer Service (excluding Call Center)	Customer Service (excluding Call Center) - N/A	Customer Service (excluding Call Center) - 1-3 Years	Customer Service (excluding Call Center) - 4-8 Years	Customer Service (excluding Call Center) - 9+ Years
Data Analysis	Data Analysis - N/A	Data Analysis - 1-3 Years	Data Analysis - 4-8 Years	Data Analysis - 9+ Years
Data Entry	Data Entry - N/A	Data Entry - 1-3 Years	Data Entry - 4-8 Years	Data Entry - 9+ Years
Dietitian	Dietitian - N/A	Dietitian - 1-3 Years	Dietitian - 4-8 Years	Dietitian - 9+ Years
Emergency Operations Center	Emergency Operations Center - N/A	Emergency Operations Center - 1-3 Years	Emergency Operations Center - 4-8 Years	Emergency Operations Center - 9+ Years
Department Operations Center	Department Operations Center - N/A	Department Operations Center - 1-3 Years	Department Operations Center - 4-8 Years	Department Operations Center - 9+ Years
Incident Command Post	Incident Command Post - N/A	Incident Command Post - 1-3 Years	Incident Command Post - 4-8 Years	Incident Command Post - 9+ Years
Emergency Medical Technician	Emergency Medical Technician - N/A	Emergency Medical Technician - 1-3 Years	Emergency Medical Technician - 4-8 Years	Emergency Medical Technician - 9+ Years
Empathy, Listening, and Soft Skills	Empathy, Listening, and Soft Skills - N/A	Empathy, Listening, and Soft Skills - 1-3 Years	Empathy, Listening, and Soft Skills - 4-8 Years	Empathy, Listening, and Soft Skills - 9+ Years
Finance/Accounting	Finance/Accounting - N/A	Finance/Accounting - 1-3 Years	Finance/Accounting - 4-8 Years	Finance/Accounting - 9+ Years
Firefighter	Firefighter - N/A	Firefighter - 1-3 Years	Firefighter - 4-8 Years	Firefighter - 9+ Years
Food Services	Food Services - N/A	Food Services - 1-3 Years	Food Services - 4-8 Years	Food Services - 9+ Years
Heavy Equipment Operator	Heavy Equipment Operator - N/A	Heavy Equipment Operator - 1-3 Years	Heavy Equipment Operator - 4-8 Years	Heavy Equipment Operator - 9+ Years
Housekeeping	Housekeeping - N/A	Housekeeping - 1-3 Years	Housekeeping - 4-8 Years	Housekeeping - 9+ Years
Infection Control Nurse	Infection Control Nurse - N/A	Infection Control Nurse - 1-3 Years	Infection Control Nurse - 4-8 Years	Infection Control Nurse - 9+ Years
IT Database Administration	IT Database Administration - N/A	IT Database Administration - 1-3 Years	IT Database Administration - 4-8 Years	IT Database Administration - 9+ Years
IT Desktop and Technical Support Services	IT Desktop and Technical Support Services - N/A	IT Desktop and Technical Support Services - 1-3 Years	IT Desktop and Technical Support Services - 4-8 Years	IT Desktop and Technical Support Services - 9+ Years
IT GIS (Geographic Information Systems)	IT GIS (Geographic Information Systems) - N/A	IT GIS (Geographic Information Systems) - 1-3 Years	IT GIS (Geographic Information Systems) - 4-8 Years	IT GIS (Geographic Information Systems) - 9+ Years
IT Infrastructure/Networks	IT Infrastructure/Networks - N/A	IT Infrastructure/Networks - 1-3 Years	IT Infrastructure/Networks - 4-8 Years	IT Infrastructure/Networks - 9+ Years
IT Software Development	IT Software Development - N/A	IT Software Development - 1-3 Years	IT Software Development - 4-8 Years	IT Software Development - 9+ Years
IT Telecommunications	IT Telecommunications - N/A	IT Telecommunications - 1-3 Years	IT Telecommunications - 4-8 Years	IT Telecommunications - 9+ Years
IT Web Content Management	IT Web Content Management - N/A	IT Web Content Management - 1-3 Years	IT Web Content Management - 4-8 Years	IT Web Content Management - 9+ Years
Investigative Services	Investigative Services - N/A	Investigative Services - 1-3 Years	Investigative Services - 4-8 Years	Investigative Services - 9+ Years
Juvenile Detention Officer	Juvenile Detention Officer - N/A	Juvenile Detention Officer - 1-3 Years	Juvenile Detention Officer - 4-8 Years	Juvenile Detention Officer - 9+ Years
Law Enforcement (police/sheriff)	Law Enforcement (police/sheriff) - N/A	Law Enforcement (police/sheriff) - 1-3 Years	Law Enforcement (police/sheriff) - 4-8 Years	Law Enforcement (police/sheriff) - 9+ Years
Licensed Vocational Nurse	Licensed Vocational Nurse - N/A	Licensed Vocational Nurse - 1-3 Years	Licensed Vocational Nurse - 4-8 Years	Licensed Vocational Nurse - 9+ Years
Medical Billing	Medical Billing - N/A	Medical Billing - 1-3 Years	Medical Billing - 4-8 Years	Medical Billing - 9+ Years
Medical Records Clerk	Medical Records Clerk - N/A	Medical Records Clerk - 1-3 Years	Medical Records Clerk - 4-8 Years	Medical Records Clerk - 9+ Years
Mental Health Lead	Mental Health Lead - N/A	Mental Health Lead - 1-3 Years	Mental Health Lead - 4-8 Years	Mental Health Lead - 9+ Years
Microsoft Word	Microsoft Word - N/A	Microsoft Word - 1-3 Years	Microsoft Word - 4-8 Years	Microsoft Word - 9+ Years
Microsoft Excel	Microsoft Excel - N/A	Microsoft Excel - 1-3 Years	Microsoft Excel - 4-8 Years	Microsoft Excel - 9+ Years
Nurse Practitioner	Nurse Practitioner - N/A	Nurse Practitioner - 1-3 Years	Nurse Practitioner - 4-8 Years	Nurse Practitioner - 9+ Years
Nursing Assistant/Certified Nursing Assistant	Nursing Assistant/Certified Nursing Assistant - N/A	Nursing Assistant/Certified Nursing Assistant - 1-3 Years	Nursing Assistant/Certified Nursing Assistant - 4-8 Years	Nursing Assistant/Certified Nursing Assistant - 9+ Years
Paramedic	Paramedic - N/A	Paramedic - 1-3 Years	Paramedic - 4-8 Years	Paramedic - 9+ Years
Patient Care Tech	Patient Care Tech - N/A	Patient Care Tech - 1-3 Years	Patient Care Tech - 4-8 Years	Patient Care Tech - 9+ Years
Patient Transportation (Ambulatory)	Patient Transportation (Ambulatory) - N/A	Patient Transportation (Ambulatory) - 1-3 Years	Patient Transportation (Ambulatory) - 4-8 Years	Patient Transportation (Ambulatory) - 9+ Years
Patient Transportation (Non-Ambulatory)	Patient Transportation (Non-Ambulatory) - N/A	Patient Transportation (Non-Ambulatory) - 1-3 Years	Patient Transportation (Non-Ambulatory) - 4-8 Years	Patient Transportation (Non-Ambulatory) - 9+ Years
Pharmacist	Pharmacist - N/A	Pharmacist - 1-3 Years	Pharmacist - 4-8 Years	Pharmacist - 9+ Years
Pharmacist Technician	Pharmacist Technician - N/A	Pharmacist Technician - 1-3 Years	Pharmacist Technician - 4-8 Years	Pharmacist Technician - 9+ Years
Phlebotomist	Phlebotomist - N/A	Phlebotomist - 1-3 Years	Phlebotomist - 4-8 Years	Phlebotomist - 9+ Years
Physical Therapist	Physical Therapist - N/A	Physical Therapist - 1-3 Years	Physical Therapist - 4-8 Years	Physical Therapist - 9+ Years
Physician	Physician - N/A	Physician - 1-3 Years	Physician - 4-8 Years	Physician - 9+ Years
Physician Assistant	Physician Assistant - N/A	Physician Assistant - 1-3 Years	Physician Assistant - 4-8 Years	Physician Assistant - 9+ Years
Probation Officer	Probation Officer - N/A	Probation Officer - 1-3 Years	Probation Officer - 4-8 Years	Probation Officer - 9+ Years
Public Relations	Public Relations - N/A	Public Relations - 1-3 Years	Public Relations - 4-8 Years	Public Relations - 9+ Years
Registered Nurse	Registered Nurse - N/A	Registered Nurse - 1-3 Years	Registered Nurse - 4-8 Years	Registered Nurse - 9+ Years
Registration	Registration - N/A	Registration - 1-3 Years	Registration - 4-8 Years	Registration - 9+ Years
Respiratory Therapist	Respiratory Therapist - N/A	Respiratory Therapist - 1-3 Years	Respiratory Therapist - 4-8 Years	Respiratory Therapist - 9+ Years
Security	Security - N/A	Security - 1-3 Years	Security - 4-8 Years	Security - 9+ Years
Social Media	Social Media - N/A	Social Media - 1-3 Years	Social Media - 4-8 Years	Social Media - 9+ Years
Spiritual Support	Spiritual Support - N/A	Spiritual Support - 1-3 Years	Spiritual Support - 4-8 Years	Spiritual Support - 9+ Years
Transportation (driving, moving items, food delivery, etc.)	Transportation (driving, moving items, food delivery, etc.) - N/A	Transportation (driving, moving items, food delivery, etc.) - 1-3 Years	Transportation (driving, moving items, food delivery, etc.) - 4-8 Years	Transportation (driving, moving items, food delivery, etc.) - 9+ Years
Working with Homeless and/or Disenfranchised Population	Working with Homeless and/or Disenfranchised Population - N/A	Working with Homeless and/or Disenfranchised Population - 1-3 Years	Working with Homeless and/or Disenfranchised Population - 4-8 Years	Working with Homeless and/or Disenfranchised Population - 9+ Years
Working in Shelters/Housing Services	Working in Shelters/Housing Services - N/A	Working in Shelters/Housing Services - 1-3 Years	Working in Shelters/Housing Services - 4-8 Years	Working in Shelters/Housing Services - 9+ Years
X-Ray Technician	X-Ray Technician - N/A	X-Ray Technician - 1-3 Years	X-Ray Technician - 4-8 Years	X-Ray Technician - 9+ Years

Additional Skills

Languages (Please rate your experience level with the following written and verbal languages)

Language

	N/A	Beginner	Intermediate	Advanced
Spanish — Verbal	Spanish — Verbal - N/A	Spanish — Verbal - Beginner	Spanish — Verbal - Intermediate	Spanish — Verbal - Advanced
Spanish — Written	Spanish — Written - N/A	Spanish — Written - Beginner	Spanish — Written - Intermediate	Spanish — Written - Advanced
Mien — Verbal	Mien — Verbal - N/A	Mien — Verbal - Beginner	Mien — Verbal - Intermediate	Mien — Verbal - Advanced
Mien — Written	Mien — Written - N/A	Mien — Written - Beginner	Mien — Written - Intermediate	Mien — Written - Advanced
American Sign Language (ASL) — Verbal	American Sign Language (ASL) — Verbal - N/A	American Sign Language (ASL) — Verbal - Beginner	American Sign Language (ASL) — Verbal - Intermediate	American Sign Language (ASL) — Verbal - Advanced
Arabic — Verbal	Arabic — Verbal - N/A	Arabic — Verbal - Beginner	Arabic — Verbal - Intermediate	Arabic — Verbal - Advanced
Arabic — Written	Arabic — Written - N/A	Arabic — Written - Beginner	Arabic — Written - Intermediate	Arabic — Written - Advanced
Cambodian — Verbal	Cambodian — Verbal - N/A	Cambodian — Verbal - Beginner	Cambodian — Verbal - Intermediate	Cambodian — Verbal - Advanced
Cambodian — Written	Cambodian — Written - N/A	Cambodian — Written - Beginner	Cambodian — Written - Intermediate	Cambodian — Written - Advanced
Cantonese — Verbal	Cantonese — Verbal - N/A	Cantonese — Verbal - Beginner	Cantonese — Verbal - Intermediate	Cantonese — Verbal - Advanced
Cantonese — Written	Cantonese — Written - N/A	Cantonese — Written - Beginner	Cantonese — Written - Intermediate	Cantonese — Written - Advanced
Farsi — Verbal	Farsi — Verbal - N/A	Farsi — Verbal - Beginner	Farsi — Verbal - Intermediate	Farsi — Verbal - Advanced
Farsi — Written	Farsi — Written - N/A	Farsi — Written - Beginner	Farsi — Written - Intermediate	Farsi — Written - Advanced
Hindi — Verbal	Hindi — Verbal - N/A	Hindi — Verbal - Beginner	Hindi — Verbal - Intermediate	Hindi — Verbal - Advanced
Hindi — Written	Hindi — Written - N/A	Hindi — Written - Beginner	Hindi — Written - Intermediate	Hindi — Written - Advanced
Hmong — Verbal	Hmong — Verbal - N/A	Hmong — Verbal - Beginner	Hmong — Verbal - Intermediate	Hmong — Verbal - Advanced
Hmong — Written	Hmong — Written - N/A	Hmong — Written - Beginner	Hmong — Written - Intermediate	Hmong — Written - Advanced
Laotian — Verbal	Laotian — Verbal - N/A	Laotian — Verbal - Beginner	Laotian — Verbal - Intermediate	Laotian — Verbal - Advanced
Laotian — Written	Laotian — Written - N/A	Laotian — Written - Beginner	Laotian — Written - Intermediate	Laotian — Written - Advanced
Mandarin — Verbal	Mandarin — Verbal - N/A	Mandarin — Verbal - Beginner	Mandarin — Verbal - Intermediate	Mandarin — Verbal - Advanced
Mandarin — Written	Mandarin — Written - N/A	Mandarin — Written - Beginner	Mandarin — Written - Intermediate	Mandarin — Written - Advanced
Nepalese — Verbal	Nepalese — Verbal - N/A	Nepalese — Verbal - Beginner	Nepalese — Verbal - Intermediate	Nepalese — Verbal - Advanced
Nepalese — Written	Nepalese — Written - N/A	Nepalese — Written - Beginner	Nepalese — Written - Intermediate	Nepalese — Written - Advanced
Portuguese — Verbal	Portuguese — Verbal - N/A	Portuguese — Verbal - Beginner	Portuguese — Verbal - Intermediate	Portuguese — Verbal - Advanced
Portuguese — Written	Portuguese — Written - N/A	Portuguese — Written - Beginner	Portuguese — Written - Intermediate	Portuguese — Written - Advanced
Punjabi — Verbal	Punjabi — Verbal - N/A	Punjabi — Verbal - Beginner	Punjabi — Verbal - Intermediate	Punjabi — Verbal - Advanced
Punjabi — Written	Punjabi — Written - N/A	Punjabi — Written - Beginner	Punjabi — Written - Intermediate	Punjabi — Written - Advanced
Russian — Verbal	Russian — Verbal - N/A	Russian — Verbal - Beginner	Russian — Verbal - Intermediate	Russian — Verbal - Advanced
Russian — Written	Russian — Written - N/A	Russian — Written - Beginner	Russian — Written - Intermediate	Russian — Written - Advanced
Tagalog — Verbal	Tagalog — Verbal - N/A	Tagalog — Verbal - Beginner	Tagalog — Verbal - Intermediate	Tagalog — Verbal - Advanced
Tagalog — Written	Tagalog — Written - N/A	Tagalog — Written - Beginner	Tagalog — Written - Intermediate	Tagalog — Written - Advanced
Vietnamese — Verbal	Vietnamese — Verbal - N/A	Vietnamese — Verbal - Beginner	Vietnamese — Verbal - Intermediate	Vietnamese — Verbal - Advanced
Vietnamese — Written	Vietnamese — Written - N/A	Vietnamese — Written - Beginner	Vietnamese — Written - Intermediate	Vietnamese — Written - Advanced

Additional Languages

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