ESC Application

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Personal Data & Contact Information

First Name *

Middle Name

Last Name *

Preferred Name

Email *

Cell Phone *

Address Line 1 *

Address Line 2

City *

Territory - for international addresses

State/Province *

Zip/Postal Code *

Country

Birthday

Home Church - Name

Home Church - City

Home Church - State

Certifications

Please upload the certificates you have completed in the corresponding type below.

Also fill in the course Completion Date for each form, not today's date.

To keep your uploads separate in our protected documents file, please use this format to name your files before you upload them:

Last Name_First Name_Certificate Title_Completed Date
example: Doe_John_CPR Ceritification_08-31-26

IS-0100 Certificate

IS-0100 Incident Command Certificate Completed Date

Grief Following Trauma Certificate

Grief Following Trauma Certificate Completed Date

CPR Certificate (good for 3 yrs)

Skills & Expertise

This will help us identify your specific skills and assist in placing you on a work detail in the field. If you are skilled in more than one area, please choose the skill in which you are the most proficient from the selections below.

On most deployments, ESC providers will also need to work on the jobsite, in addition to providing care to homeowners and survivors.

Secondary Language Spoken

Construction Area of Expertise

Medical Area of Expertise

Emotional and Spiritual Care

What other skills/experience/contacts do you have that would be good for deployment?

Disclaimer

I understand and agree that submitting this application form does not automatically qualify me as a Hope Force volunteer, and that there may be certain qualifications I must meet, including the acceptance of established volunteer policies and procedures, before I begin volunteering. *

I agree

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HFI Emotional and Spiritual Care New Volunteer Form