FD/EMS Agency Officers Update Form

Read all notes. Please complete all appropriate fields that apply to your organization/officers.

NOTES:

It’s imperative that we have cell phone numbers, email addresses and other pertinent contact info for each member of your leadership team as we may need to contact these individuals in an emergency, or non-emergency related to projects, programs or issues affecting your agency and our emergency services community.

Thanks in advance for your cooperation in completing this form and keeping your contact information up to date anytime there are changes in officers.

Third Assistant Chief: Check the box if this position is also designated as your EMS Chief, as is the case in many fire departments.
EMS Coordinator: Check the appropriate box if this position is also designated as your EMS Chief or filled by your EMS Captain.
IamResponding System Administrator – As previously shared under an Alerting System memo, this person has the authority to make decisions about agency and end user implementation, configuration, access, rights and privileges. This person should be a chief or administrative officer who is tech-savvy and responsive to timely electronic communications from our office or their dispatch center as it relates to implementation, configuration and use of this system. They will monitor and direct the work of the Data Coordinator(s).
IamResponding Primary Data Coordinator - This person is authorized and responsible for entering your agency’s information as well as setting up and maintaining end user accounts, rights and privileges as directed by the System Administrator. They will be the ones coordinating the validity of information entered and ensuring that discipline is maintained in entering information consistently. This person should be a trusted member who is comfortable and adept at data entry and utilizing database software and apps. They too must be responsive to timely electronic communications from our office or their dispatch center as it relates to implementation, configuration and use of this system. They may also be a good candidate for training end users in your agency. While it’s recommended that a back-up person be assigned to this position, having more than two data coordinators is discouraged in that it could create inconsistencies in how information is entered or accounts are configured.
IamResponding Secondary Data Coordinator – This person is designated as the back-up to the Primary Data Coordinator and shares the same system access rights and responsibilities.

For their convenience, we will automatically include all of the officers you list above on our eNewsletter “The Training Ground” email distribution list to receive advance notice of training opportunities and other events. If all of your responders are not signed up for this distribution list, they’re missing out on important informational updates and could lose out on securing class seats as so many courses fill up quickly after they’re announced. Encourage all of your other members to sign up for our distribution list at www.erie.gov/FIRE.

And please remind them (and their friends and families) to sign up for the ReadyErie App to receive critical information and emergeny alerts, and create a personalized Emergency Preparedness Plan!

Connect with us via www.erie.gov/fire, on YouTube, on our Facebook page at: https://www.facebook.com/ErieCountyESU/, and via our Twitter feed: https://twitter.com/ErieCountyESU

OFFICERS FOR THE YEAR: *

FD/EMS AGENCY: *

Agency Mailing Address: *

PO Box:

City: *

ST: *

Zip: *

General FD/Agency Email:

Web Site: www.

Facebook Page: Facebook.com/

Twitter Handle: @

STATION#1 Street Address: *

Station#1 Phone: *

Station#1 Fax:

STATION#2 Street Address:

Station#2 Phone:

Station#2 Fax:

STATION#3 Street Address:

Station#3 Phone:

Station#3 Fax:

FD/EMS AGENCY CHIEF: *

Home Address (Including City/State/Zip): *

Home Phone:

Work Phone:

Cell Phone: *

Email: *

FIRST ASSISTANT CHIEF:

Cell Phone:

Email:

SECOND ASSISTANT CHIEF:

Cell Phone:

Email: *

THIRD ASSISTANT CHIEF:

Cell Phone:

Email:

EMS COORDINATOR:

Cell Phone:

Email:

TRAINING OFFICER: *

Cell Phone: *

Email: *

PRESIDENT: *

Home Address: *

Home Phone:

Work Phone:

Cell Phone: *

Email: *

RECRUITER: *

Cell Phone: *

Email: *

IamResponding SYSTEM ADMINISTRATOR: *

Cell Phone: *

Email: *

IamResponding PRIMARY DATA COORDINATOR: *

Cell Phone: *

Email: *

IamResponding SECONDARY DATA COORDINATOR: *

Cell Phone: *

Email: *

MONTHLY ORGANIZATIONAL MEETINGS ARE HELD:

Example: (First, Second, Third, Fourth, Last) / (Monday, Tuesday, Wednesday, Thursday, Friday, Saturday, Sunday) of the Month

ANNUAL ELECTIONS HELD IN:

Comments:

SUBMITTED BY: *

Rank/Title: *

Cell Phone: *

Email: *

Please email copy of this list to another officer:

A copy of this completed form will automatically be sent back to the person who entered their contact information in the "SUBMITTED BY:" field.