Please take a moment to fill in the appropriate information below to be notified by your local emergency response team in the event of emergency situations or critical community alerts. Examples include: evacuation notices, bio-terrorism alerts, boil water notices, and missing child reports.

*Required fields

*First Name *Last Name


*Address (Physical only, no P.O. boxes.) Apartment, Suite, or Unit Number

*City *State *Zip Plus4



Email Address  

 

*Primary Phone
Alternate Phone

*Example: 3866760294
*Example: 3866760294
Primary Phone Number is required
ALTERNATE PHONE NUMBER--- Entering an alternate phone number will cause BOTH the primary and alternate phone numbers to be contacted in the event a call goes out for the address specified.
TDD/TTY--- Check TDD ONLY if you are hearing impaired and would like tone delivery of emergency messages - messages delivered to phone numbers marked TDD will ONLY be delivered in a TDD/TTY format.
For Primary phone with a hearing impaired TDD/TTY device Check this box:
For Alternate phone with a hearing impaired TDD/TTY device Check this box:

If you live in MOBILE HOME or MANUFACTURED HOME please check this box: