Order form: Emergency Response Guidebook

Notes

• Fill out the information to the best of your knowledge
• Do not provide personal contact information, only provide your professional contact information

How to fill in the form

• Name of the emergency service – Provide the name of your emergency service
• Type of emergency service – Select the primary emergency service you provide, only one option may be chosen
• Are you ordering on behalf of other departments? – If you are placing an order on behalf of other department(s), indicate the name(s) of the department(s) and the type of service(s) offered
• Number of vehicles – Indicate how many vehicles are used to respond to incidents
• Number of English copies – Indicate how many English copies of the ERG you would like to receive
• Number of French copies – Indicate how many French copies of the ERG you would like to receive
• Additional information – Please justify your request if it does not abide by our distribution policy or add any additional information deemed necessary for the submission
• Shipping address – Indicate the address where the ERG(s) will be shipped
• Physical address – Fill out if the physical address of your emergency service is different from the shipping address
• Contact name – Indicate the name of the person requesting the ERG(s)
• Job title – Indicate the job title of the person requesting the ERG(s)
• Email – Indicate the work email address of the person requesting the ERG(s)
• Website – Provide your organization’s website, if applicable
• Phone number – Provide your phone number to contact you at work, if applicable
• Emergency service phone number – Provide your organization’s phone number, if applicable
• Fax number – Provide your organization’s fax number, if applicable
• Toll-free number – Provide your organization’s toll-free telephone number, if applicable