CRISIS BUNKER RESILIENCE HUB DISASTER READINESS NEEDS ASSESSMENT

CRISIS BUNKER RESILIENCE HUB DISASTER READINESS NEEDS ASSESSMENT

Please fill out this form to provide necessary information for your Disaster Readiness Project
Name of your Entity (e.g. XYZ Marae)*
Where is the location for the disaster readiness project?*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Who is the key contact person (and position) for this project?
Full Name*

First NameLast Name
Position (e.g. Chair)
Contact Phone Number*
Please enter a valid phone number.
Email*
example@example.com
What are the natural hazards/risks in your location?

FloodingLandslidesLiquefactionEarthquakeForest FireTsunamiPhysical/geographical isolationOther (Please specify)
Do you have a (current) Emergency Preparedness Plan?

YesNoIn progressUnsure
Who have you engaged with in the preparedness planning process?

IwiHapu or RunangaCommunity leadersCivil Defense/Local CouncilFENZ (Fire Emergency NZ)None of the aboveOther (Please specify)
Indicate the numbers of people/population that would require support during a disaster.

10 - 2030 - 5050 - 8080 - 100100 - 250250+
Do you require a Fixed Location Hub (Shipping Container Based) or Mobile Hub (Trailer)

Fixed (Shipping container)Mobile (Trailer based)Not Sure yet
What disaster preparedness resources do you require?

Backup Power GeneratorStarlink Satellite SystemCommunications system (external - to Civil Defense HQ, other Marae etc)Communications system (internal - for around the site)Mobile BBQ's and Gas BottlesCompact Gas CookersRain water harvesting systemBottled waterLong shelf life food rationsEasy Prep mealsGazebo'sTentsBedding (mattresses, stretchers, sleeping bags)Power banksTemporary cooking facilitiesSanitation and hygiene gear (cleaning, PPE, personal hygiene, nappies, biohazard bags)Pet food (domestic animals)Tool kit (e.g. spade, shovel, screwdrivers, hammer etc.)Emergency clothing (raincoats, gumboots, high vis)Commercial first aid kitCommercial burns treatment kitFire extinguisherTemporary toiletsTemporary showersTorchesSurvival backpacks (personal preparedness backpacks)Unsure - I would like to talk about this furtherOther (Please specify)
Do your volunteers require any of the following training?

First AidPsychosocial first aid for emergency responseCIMS - (coordinated incident management systems)Scenario training - CDEMEmergency communicationsOther (Please specify)
Will you require funding application assistance/advice from Crisis Bunker for your disaster preparedness project?

YesNoWish to discuss
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CRISIS BUNKER RESILIENCE HUB DISASTER READINESS NEEDS ASSESSMENT

Who is the key contact person (and position) for this project?