Application Form

Please complete this section so we will be able to contact you.

In the event of an emergency whom should we notify? Please list one or two people.

The following information is required for us to maintain a complete file on each of our Strike Team Members. As part of submitting an application, you understand we will perform a background check and because your assignment could entail driving a vehicle we need to ensure you have a valid drivers licence. Your information is maintained on a secure site that is protected from public view. Due to the quick response required at the time of activation, we need to have all of this information verified and on file prior to the activation phase. Thank you for your assistance in this endeavor.

Please answer the medical Lic./Cert and education question. Also, in the list below, please check all that apply.

We like to keep Strike Team Members informed of important news and developments by email. If you have a second email or a "Non-work email, please add this here. We find that when people change jobs, their email does not always follow them. This would give us a way to locate you when the primary email no longer works.

Please indicate the number of days of deployment you would be available, on average, at one time. Please include/consider 2 travel days in the total days available.

If you have commitments to any other emergency response groups or organizations, please check the box and list them.

I understand and agree that submitting this application form does not automatically register me as a Response Systems Inc Strike Team Member, and that there may be certain qualifications I must meet. I further acknowledge that Response Systems Inc may perform a background check and Drivers Licence verification due to the nature of the work to be performed. By submitting this form, I attest that the information I have provided on the form is true and accurate.