Disaster Service Worker "DSW" Form

You can download the form below, fill it in electronically or print, fill, photograph. Either way, please send the completed form to records@wpv-cert.org 

Since this form is not entirely obvious, here is a picture of the form fields we would like you to fill in shaded green. Please note your required signature near the bottom. Do not fill out the last line (Date, Signature, Title) that is for Selena.