Crisis Response International

Responder Profile

Completion of this profile is mandatory in order to deploy with CRI

* First Name

* Last Name

* Email

* Address

* City

* State

* Country

* Postal Code

* Mobile Phone

* Birthday

* Gender

Emergency Contact

* Emergency Contact

* Emergency Phone

* Relationship

Medical History

* aa. Please rate your health from 1 to 10: 1-very unhealthy, 5-average health, 10-excellent:

* ab. List chronic health conditions that CRI needs to be aware of:

* ac. Do you have any mobility limitations?

* ad. Do You Have Medical Insurance?

ae. Name of Your Insurance Provider:

Criminal History

* af. Upon completion of your training, will you consent to a background check? (Required to become a certified CRI responder and to deploy)

* ag. Have you ever been convicted of a felony?

ah. If yes, please give felony date(s) and explanation.

* ai. Have you ever been convicted of a sexual crime?

aj. If yes, please give date(s) and explanation.

CRI Training

* ak. Are you a CRI trained responder?

* al. Did you complete your CRI Training online?

am. If yes, what course(s) did you take online?

* an. CRI Rapid Training (Y/N) (2/3 day training):

ao. If yes, please list date(s) & location(s) of Rapid Training:

* ap. DRS-Disaster Relief Seminar (Y/N) (2/3 day training):

aq. If yes, please list date(s) & location(s) of DRS:

* ar. CRI Basic Training CRT (Y/N) (5-day training):

as. If yes, please list date(s) & location(s) of Basic Training:

* at. CRI Advanced Training ATS (Y/N):

au. If yes, please list date(s) & location(s) of ATS:

* av. CRI ARC (Apostolic Response to Crisis) Training (Y/N):

aw. If yes, please list date(s) & location(s) of ARC School:

ax. Other Related Training:

Chaplaincy

* ay. CRI Chaplaincy Level

* az. CRI Chaplaincy Desire

ba. Other relevant Chaplaincy Training:

Deployments

* bb. Deployments Attended:

bc. Briefly describe any prior deployment experiences:

* bd. Have you ever been a CRI Deployment Leader

* bc. Have you ever been a CRI Team Leader

* bf. Deployment Leader Desire:

* bg. What should we expect from you during a deployment?

* bh. Are you willing to submit to being monitored and lovingly corrected if necessary?

* bi. Are you willing to minister within CRí ministry guidelines?

Skills Assessment

* bj. Responder Skills:

bk. If you speak another language indicate here your level of fluency.

bl. If you are an MD please indicate here the type of medicine you practice.

bm. Please list all relevant certifications and expiration dates:

bn. Any additional comments?

Pastoral Reference

* bo. Name of Your Church:

* bp. Your Pastor's Name:

* bq. Your Church/Pastor's Phone Number:

br. Your Pastor's Email:

Please upload a forward-facing, headshot photo (passport type)

* Photo

* bs. T-Shirt Size

* Please type your full legal name to confirm you are submitting information that is accurate and correct to the best of your knowledge.

Thanks for joining the CRI Team!

Crisis Response International (CRI) resources, trains and mobilizes volunteers, churches and other organizations to respond to disasters and compassion initiatives around the world.