STAFF SKILLS INVENTORY FORM

Building personnel are asked to complete the following information to aid the principal in
selecting and appointing the Building Response Team. Individuals may volunteer for the Team,
but best practice calls for teams to be selected based on experience and/or personal
strengths.

Please check any of the following in which you have expertise or training:

EMERGENCY RESPONSE EXPERIENCE:

CPR Search & Rescue Grief or Trauma Counseling

EMT Law Enforcement Crisis Training

First Aid Emergency Management CB/Ham Radio Usage

Fire Fighting Bi/multilingual (Specify):

Is your training/certification in the areas noted current? Please specify.

Explain your experience or note any other expertise you possess that may be beneficial
to the Building Response Team:

Are you interested and willing to serve on the Building Response Team if selected?

Please list the name(s) of other individuals in the building who you believe would be an
asset to the Building Response Team based on their experience or personal qualities:

Signature Date