Home
Departments
Mayor
Assembly/Clerk
My Neighborhood
Employee Directory
Contact Us
Find
First Name:
Last Name:
Home Address:
City:
Zip:
Your Phone number:
What is your primary condition that makes you vulnerable to a disaster? (Examples: Insulin-dependent, live alone without support,vision-impaired, need oxygen, wheelchair user, etc.)
Name and phone number of an emergency contact person who does not live with you:
Name:
Phone:
Please check the box next to the type of assistance you may require during an emergency:
I may need transportation assistance if an evacuation is required
I would like someone to call me or check in on me after a disaster
Please select the fire station closest to your home
Stn. 1: 122 E. 4th Ave. (4th & Barrow)
Northside
Stn. 3: 1100 Airport Heights Rd
Stn. 5: Spenard & McRae
Stn. 4: Tudor & Macinnes
Eastside
Stn. 6: DeBarr & Patterson
Stn. 11: Bottom of Eagle River Rd
Stn. 14: 4501 Campbell Airstrip Rd
Southside
Stn. 7: Jewel Lake & W. 88th
Stn. 8: 6151 O'Malley Rd
Stn. 9: 1148 Huffman Rd.
Stn. 10: Top of Rabbit Creek Rd
Stn. 12: New Seward & Dimond
Stn. 15: 11301 Southport Dr
Outside Anchorage
Girdwood Fire and Rescue
Chugiak-Eagle River VFD
I authorize this information to be maintained confidentially at the Anchorage Office of Emergency Management and the Fire Department for use only during an emergency that may affect me or my home. Information submitted on this form will not be shared with unauthorized persons or organizations. Authorized release will only occur in a disaster or emergency situation to effect delivery of aid to the registered party.
DISASTER REGISTRY
For vulnerable seniors and persons with disabilities