Pre-Register Your Household for Assistance – Unity Township Bureau Of Fire

Pre-register in our incident software if your family needs special care in the event of an emergency, E.g., attention to impaired or handicapped occupants.

Consent

I agree to the privacy policy.

By consenting, and submitting this form you agree to have the data submitted stored in our secured pre-incident software. Also, you consent to a representative from the Unity Township Bureau of Fire contacting you for additional information or clarity of information submitted.

First Name

Last Name

Address

Phone

Do you have smoke detectors?

Yes No

Type of assistance