Universal Alert Form

Initial Update

Please only Indicate stations you wish to receive calls from

For short notice call-offs and potential future use for long term scheduling

Please only indicate Counties of which you wish to staff

Additional Vehicles

Please only Indicate stations you can first respond for

This Should be stations within a close vicinity to your residence

Yes No

Be advised that your cellular carrier may charge you additional fees for receiving text messages

and that SEOEMS District will not be responsible for any costs you incur

Each employee can have two phone numbers

Please indicate primary and secondary
Examples LandPhone P: 740-446-9840 S: 740-446-9820
Examples CellPhone PC: 740-645-0001 SC: 740-645-0011

ATT, Version, Sprint . .