Severe Weather Safety Notice
Please review this notice, follow all safety instructions, and acknowledge your understanding regarding the current severe weather situation.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Department / Location
*
Type of Severe Weather
*
Please Select
Thunderstorm
Tornado
Flood
Hurricane
Snowstorm
Heatwave
Other
Date of Notice
*
-
Month
-
Day
Year
Date
Safety Instructions Provided
*
Shelter in place
Evacuate to designated area
Monitor local news and alerts
Other
Have you reviewed and understood the safety procedures?
*
Yes, I have reviewed and understood.
No, I need more information.
Emergency Contact Name
Emergency Contact Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Additional Comments or Questions
Acknowledge and Submit
Should be Empty: