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Ohio TERT Application
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Date
(Required)
MM slash DD slash YYYY
Name
(Required)
First
Middle
Last
Title/Position
(Required)
Agency
(Required)
Address
(Required)
Street Address
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Phone
(Required)
Email
(Required)
Certifications/Requirements
Minimum 2 years full time dispatching
Background check (BCI/FBI)
CJIS Level 4 (or higher)
NIMS 100, 200, and 700 (for TERT basic awareness)
TERT Basic Awareness Course
TERT Team Leader Course (if applicable)
NIMS 100, 200, 700, 800, and 1200 (for team leaders)
Hazmat Awareness Training
Valid Driver's License
Additional Certifications
Member Recommendation
A letter of recommendation must be provided by a supervisor, manager, or administrator. Please provide the necessary contact information below and we will reach out to him/her directly.
Supervisor Name
(Required)
First
Last
Supervisor Email
(Required)
Acknowledgements
Requirement Cerification
(Required)
I certify I have met the minimum qualifications required to become an OH-TERT member.
TERT Contract of Commitment
(Required)
I understand that being a member of the Ohio Telecommunicator Emergency Response Taskforce (TERT) is a great honor. However, I also understand that it is a commitment that I must be willing to make voluntarily and with full knowledge of what is expected of me.
I am aware that an intrastate deployment is a minimum of four (4) days and that the minimum required for an interstate deployment is fourteen (14) days.
During this deployment phase, I realize that I will be expected to sleep in less-than-ideal situations (on the floor, in a vehicle, in a room with others, etc.) and that personal hygiene will be less than I am normally accustomed to (no showers, electricity, running water, etc.). I am also fully aware that food options may be scarce and that I should prepare 72 hours’ worth of food/water for myself. I should also provide my own medications and any other items that would be necessary for me to fulfill my deployment time as outlined above.
It is recognized that I will be deployed to an area that is experiencing a distressing event. I fully comprehend that there may be resentment with my mere presence at the location and I am ready to accept this and work to the best of my ability to overcome any obstacles. I understand that I not only make an obligation to myself, but also to the Team with which I am deployed. I am aware that I must be open to direction and feedback from my Team Leader. I understand that I will be expected to work a console position, with zero to minimal training. The equipment (if any) will likely be something I am not familiar with, and my comfort level will be very minimal.
As stated above, I am fully aware of the requirements that are placed upon me in my desire to be a member of TERT. I pledge to do my best and live up to the expectations that have been placed upon me.
Signature
(Required)
First
Last
Signature Date
(Required)
MM slash DD slash YYYY
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