Community Survey Community Survey Please provide the address served by Lakeview Fire Protection District * NAME OF PERSON COMPLETING THE SURVEY * NAME OF PERSON COMPLETING THE SURVEY First First Last Last Best number to reach you in an emergency Email ADD A SECOND CONTACT (OPTIONAL) ADD A SECOND CONTACT (OPTIONAL) First First Last Last Phone WOULD YOU LIKE TO RECIEVE EMAIL UPDATES FROM THE DISTRICT? * Yes No How many people live in your household? * DOES ANYONE IN YOUR HOUSEHOLD REQUIRE ASSISTANCE DURING AN EMERGENCY? * Yes No If you marked “Yes” to the question above, please describe the assistance needed. IS THERE A STORM SHELTER ON YOUR PROPERTY? * Yes No If you answered yes, please provide a location of the shelter, brief description, and number of people expected to use the shelter. Emergency contact (Optional) Emergency contact phone number If you are human, leave this field blank. Submit Δ Share this:FacebookTwitterEmailPrintLike this:Like Loading...