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Business Owner Link

 For SIRCOMM service area businesses


Dear Business Owner/Manager:

 

Please take a moment of your time to complete the following form.  This is an emergency contact list that Southern Idaho Regional Communications Center (SIRCOMM) will use in the case of an emergency at your business.  This information is strictly confidential and will not be used for any other purpose other than emergency notification by the local emergency agencies to contact a person of your choosing in the event of an emergency at your place of business.  This emergency may be a broken window, an alarm going off, open window/door or a burglary. If you need more information on this request or would like to submit this information in a different method please contact Southern Idaho Regional Communications Operations Manager or the Technical Coordinator.  If you would to contact us in person please call 324-1344.

Contents

Please provide the following contact information:

Business name
Person Submitting information

Business Street Address

City
State    Idaho
Zip/Postal Code
Main Phone Number
Alternate Phone Number
E-mail

Please provide your first emergency contact:

Name
Title
Home Phone
Cellular Phone

Please provide your second emergency contact:

Name
Title
Home Phone
Cellular Phone

Please provide your third emergency contact:

Name
Title
Home Phone
Cellular Phone

Print out a copy of this form for your records.  Please check your records periodically and forward any updated information as soon as possible to assure that the local Emergency Agencies have your current information in the event it is needed.


John Moore
Copyright © 2004 Southern Idaho Regional Communications Center  All rights reserved.
Revised: 04/30/08.

Southern Idaho Regional Communications Center • 911 E Avenue H • Jerome, Idaho 83338 • (208) 324-1911

 

Copyright © 2006 SIRCOMM. All rights reserved.