Welcome and thank you for your interest in the Augusta DMAT team. We look forward to having you on our team. Below you will find forms needed to apply for membership to the Augusta, Georgia Disaster Medical Assistance Team.

 You will need the following forms for the initial application:

1.  Instructions for Optional Application for Federal Employment and Form OF-612. Attach a resume'.

2.  NDMS Information form

3.  Copies of Educational documents, if required

4.  Copies of Medical credentials (if applicable)

5.  Copies of ICS 100, 200, 700 and 800 certifications .

6.  Completed Credit Card application

 

At this point, you will also need to attend a fingerprinting session at a location near you. They are done by a Security Specialist with one of the regional teams OR there is a regional office in Atlanta that we can set up an appointment for you. You will have your picture made for your badge at this time as well. These are turned in simultaneously with the Application Packet.

With the fingerprint cards, there are several forms that will need to be turned in, these forms will be provided for you at the fingerprinting session.

7.  PCS – 29 Personal Identity Verification form with 2 forms of ID

8.  Request for background investigation form

9.  e-QUIP initiation request form

These will all be sent together as a packet to headquarters. Once you have successfully passed this part of the application process, you will be contacted to complete more forms to finish the application process. You will want to go ahead and print these forms out as well so that you will have the information ready and available.


e-INDUCTION PACKET

• Appointment Affidavit Form ( The Team Commander is a Notary)
  
• OF-306 Declaration of Federal Employment
  
• 1199A Direct Deposit form with 2 voided checks
  
• W-4 Federal Tax form
  
• Educational Data Update Form
  
• I-9 Employment eligibility verification form with copies of drivers license, social security card and passport (if you have one)
  
• SF 181 Ethnicity and Race Identification Form
  
• SF 256 Self – Identification of Handicap Form
  
• DHHS Record of Home Address Form

 

 e-QUIPS FORMS

• HHS Security will send new employee email with instructions
  
• SF 85 P – Questionnaire for Public Trust Position
  
• OF 612 – Applicant for Federal Employment
  
• OF 306 – Declaration for Federal Employment
  
• HHS Credit Release Form

 

If you need assistance with this process, please feel free to call one of the following:

Jane Williams RN Team Commander GA4  342 Spring Valley Rd Waynesboro, GA 30830 706-721-4951 (W) 706-836-4011 (cell) 706-410-7069 (bb) jbwillia@mail.mcg.edu	Regina Medeiros, RN Administrative Office  GA4 Trauma Coordinator Department of Surgery Medical College of Georgia Augusta, GA  30912 706-799-4698 (cell) 706-721-7520 (work) rmedeiro@mail.mcg.edu

Our meetings are held the third Tuesday at 7pm - in January, March, May, July, September, and November. We will have called meetings in between if there is a need. The meeting is held in the Operational Medicine Center on the MCG campus at the corner of Laney Walker Blvd and Rear Drive.

Thank you for your interest in the Augusta DMAT team, We look forward to having you on our team.