Emergency Management - PRISM - Resident Information Form

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Home » Emergency Management » PRISM - Resident Information Form

Emergency Management

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PRISM – Resident Information Form

Make sure you can be notified about emergency events in Huron County by completing a resident information form.

Sign up for PRISM-911 online by completing the form below
Download and mail or fax in the available PDF form
Complete the form provided by your local municipality in your recent property tax notice, and send it to PRISM-911 at the address/fax number listed on the form

PRISM-911 Registration is for HURON COUNTY Residents only.

For details on how PRISM works and when it will be used, or for assistance in completing your Resident Information Form, please view the Overview or Frequently Asked Questions pages.

Information you provide will only be used in the event of an emergency and to confirm your listing in the county-wide emergency notification system; it will not be released to any third party.

Fields marked with an asterisk (*) are required.

Resident/Business Information

* First Name:

Middle Initial:

* Last Name:

Business/Organization:

Property Address

* Municipality:

* Street/911 Number:

* Street Name:

Apt/Suite Number:

RR#:

PO Box:

City:

Province:

Postal Code:

Property Roll Number:

The roll number is a 19-digit number assigned to each property. It may be found on your property tax or assessment notice.

Phone

Please provide a phone number where audio alerts may be delivered. Secondary and alternate phone numbers will only be called when necessary.

Primary Phone

* Phone Number:

Extension: (optional)

* Location:

Secondary Phone

Phone Number:

Extension: (optional)

Location:

Alternate Phone

Phone Number:

Extension: (optional)

Location:

Email Address

ie. user@domain.com

PRISM-Care Registration (optional)

Residents who may require special care assistance in the event of an evacuation, or other emergency, may request to be registered for PRISM-Care. Information indicating your medical or special needs issues will remain confidential and will only be used by First Responders in the event of an emergency.

TTY & TTD

Do you or someone at this address require the use of a TTY or TDD device to receive phone calls?

YesNo

Assistance During Evacuation

Would you or someone at this address require assistance in the event of an evacuation?

YesNo

Additional Information

Please provide additional information so that we will be better able to assist you in an emergency situation (i.e. Mobility issues - resident uses wheelchair, or Sight issues - seeing-eye dog on premises).

You have 1000 characters left.

Send Form

* Yes, I have read and agree with the Privacy Statement and Terms of Use.

Contact Information

For further information, please contact the Manager of PRISM-911 at 519.524.8394 ext. 711.