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New Member Application

To be considered for membership with Alamosa Volunteer Search and Rescue (AVSAR), we ask that you complete the following:

This application

A brief interview with an executive board member at a team meeting

A background check completed by the Alamosa County Sheriff's Office

_______

Applicants will not be considered members until they have completed all three steps and are accepted by the executive committee.

You do not have to be a resident of Alamosa County.

Name *

First

Last

Physical Address *

City, State, Zip *

Phone Number *

Email *

Date of Birth (MM/DD/YYYY) *

Drivers License # *

What state issued your driver's license? *

Employer *

Profession: Job Title *

Is there any medical information that AVSAR or the Sheriff's Dept needs to be aware of?If so please explain (Ex: bee sting allergy, diabetes, prone to Acute Mountain Sickness) *

Emergency Contact Name *

Emergency Contact Phone Number *

Relationship to Emergency Contact *

Please describe any medical training/certifications you have. *

Please describe any skills/experience/equipment you possess that could be an asset to AVSAR. Please be specific (I.E. guiding, cross country skiing, AT skiing, sport climbing, alpine mountaineering, snow mobile, ATV, technical rope training, etc.) *

Have you worked with map and compass? *

Have you worked in or around helicopters? *

Have you worked with handheld radios? *

Are you familiar with smartphone based navigation apps? *

Do you have military experience? *

If yes, MOS?

I authorize AVSAR and/or it's agents to verify any of this information by searching appropriate information and record sources. *

Please read the above statement and initial if you accept.

Workman's Compensation is provided by Alamosa County to cover AVSAR members during all approved trainings and meetings. *

Please read the above statement and initial if you accept.

I understand that Search and Rescue is, in itself, a dangerous activity. Possible dangers are, but not limited to: falls from heights, falling objects, automobile and aircraft accidents, lightning and other weather related hazards, high altitude illnesses, equipment failures, avalanches, etc. *

Please read the above statement and initial if you accept.

I agree to follow all safety best practices in place by AVSAR and report any unsafe actions to an AVSAR officer, my team leader, or a safety officer. *

Please read the above statement and initial if you accept.

Reference Full Name 1 *

Reference 1 - Contact Number *

Reference 1 - Relationship *

Reference 1 - Length of Relationship *

Reference 1 - Time Since Last in Touch *

Reference Full Name 2 *

Reference 2 - Contact Number *

Reference 2 - Relationship *

Reference 2 - Length of Relationship *

Reference 2 - Time Since Last In Touch *

Reference Full Name 3 *

Reference 3 - Contact Number *

Reference 3 - Relationship *

Reference 3 - Length of Relationship *

Reference 3 - Time Since Last In Touch *

Phone

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