Question Title

* 1. I would like to be involved in the Palgrave Emergency Planning Group in the following way - coordination

Question Title

* 2. I would like to be involved in the Palgrave Emergency Planning Group in the following way - support roles

Question Title

* 3. Please provide your contact details if interested in these roles

Question Title

* 4. Do you have specialist skills, knowledge and experience? 

Question Title

* 5. Do you have specialist skills, knowledge and experience? (in comment box and where appropriate please indicate if self-taught (ST) or if formally qualified*)

Question Title

* 6. Do you have specialist skills, knowledge and experience?

Question Title

* 7. Do you have equipment which could be made available or shared in an emergency? Please indicate below

Question Title

* 8. If you answered any of the previous questions, please provide your contact details

Question Title

* 9. Vulnerable Persons – During an emergency the Palgrave Community Emergency Group may check on vulnerable people.  If you, or someone you know who lives in the village, can say yes to any of the categories below you may need to alert us.  

Reliant on a sole carer? Sole occupant? No transport? Mobility issues? Medical issues? Age related issues?

Do you/they rely on stair lifts or similar equipment to move between floors? 
Do you/they rely on mobility aids to move around your home / outside your home or your local area?  
Do you/they rely on volunteers, neighbours, friends or family to help you cook, clean, collect prescriptions or shop? 
Do you/they rely solely on one source of energy (Electricity or Mains Gas or Oil or LPG) for heating & cooking?

Question Title

* 10. If you, or someone you know who lives in the village, should be identified as a vulnerable person in the case of an emergency, please provide contact details

T