OHTF1 Membership Application - Online Short Form
You can also download a PDF version of the application - Click Here
Note:  We get a large number of applications.  Incomplete applications will be discarded.

Position Applying For: 

Name: 

Mailing Address: 

City:    State:    Zip: 

Daytime Phone: 

E-Mail: 

1:  Employed By: 

1A:  Are you going to apply as an agency sponsored member?
(Your employer is going to officially sponsor your participation on the team)  No Yes

1B:  Are you going to apply as a non-agency sponsored member?
(You are going to become a team member as a non-individual,
not affiliated with a sponsoring organization)   No Yes

2:  Has Employer agreed and/or will your employer agree to support your membership with OHTF1:
(Note, weather you are sponsored by an agency or not, it is recommended
that your employer approve your participation based on the need
for you to be available for deployment with no notice)  No Yes Not Yet

3:  Do you have prior emergency response experience?  No Yes

3A:  If yes, please provide details (Note your actual work experience is listed later):

4:  Have you read, and do you understand the duties/responsibilities for the position that you are considering?  No Yes

5:  Do you understand that monthly team training, as well as occasional work details, mobilization drills and quarterly meetings are required, and are you willing and able to attend these trainings:  No Yes

6:  Do you have employment responsibilities or other commitments that will hinder your ability to deploy without notice?  No Yes
If you do, please explain:
 

7:  What is the response time from your home/employment location to the general area of Wright Patterson Air Force Base: 

8:  Are you willing to receive any and all required immunizations?  No Yes

If "No", please explain: 

9:  What Knowledge, skills, abilities or experience do you have that you would like to have considered in the review of your initial membership application?