National Preparedness Month

2009 Coalition Registration

My organization agrees to be a National Preparedness Month Coalition Member.

By agreeing to be a National Preparedness Coalition Member, your organization is committing to do some kind of preparedness activity or event during the month of September.

Yes

What activities do you anticipate your organization will undertake for National Preparedness Month?

	Distribute preparedness information to your employees and stakeholders
	Include preparedness information in your newsletters, Websites, emails, invoices or paystubs
	Write opinion editorials or submit letters to the editor for local publications regarding the importance of emergency preparedness
	Host a preparedness activity, such as a blood drive or First Aid/CPR/Emergency training
	Host a preparedness event in your community, such as a "How To" seminar
	Review your organization's emergency preparedness plans with employees and encourage them to plan at home
	Some Other Activity (Please specify)
: other

What is the name of your organization?

How would you describe your organization?

: other

Your Contact Information

First Name
Last Name
Title
Address
City
State
Zip
Phone Number
Email Address
	Note: This email address will be your log-in when accessing the NPM Coalition Member Web site.

I allow the name of my organization to be used in materials about National Preparedness Month, including listed on the Ready Campaign web site.

I understand that my personal information will not be shared with the public in any way.