B. Training:
1. Orientation to MRC: on-line___ classroom___
2. Orientation to Public Health: on-line___ classroom____
3. Distributing Supplies from the National Strategic Stockpile: on-line___ class room___
4. Practicing Cross Cultural Communication: on-line___ classroom____
5. Psychological Aspects of Bioterrorism & Disaster Response: on-line___ classroom___
6. Health Literacy & Public Health: on-line____
7. Blood borne Pathogens: on-line___ classroom____
8. Red Cross Shelter Training: _____
VI. Office & Administrative Skills
A. Computer Skills
1. I routinely use a computer and can use a desktop or laptop with out difficulty. ___
2. I have limited computer skills.____
3. I cannot use a computer,____
B. Access
1. I have access to a computer at home.__
2. I have access to a computer at work.__
3. I have email at home.__
4. I have email at work.__
C. Supervision
1. Have you ever supervised staff or volunteers? Y__N__
If yes, in what capacity____________________________________________________
D. Do you have a valid drivers license? Y__N__
1. Do you have a commercial driver’s license (CDL)Y__N__
2. Do you have access to a private vehicle that you could use in case of
emergency?Y__N__
VII. Language Skills
What languages do you speak or understand other then English?
Language Spoken Fluency Able to read Able to write
______________ excellent/good/fair Y__N__ Y__N__
______________ excellent/good/fair Y__N__ Y__N__
