Neighborhood
Fire/Evacuation Drill
Application
Neighborhood / Subdivision Name: _____________________________________________________________
Total number of Homes/Units: _________________
Applicant Informaon
Name: ____________________________________________________________________________________________
Email: __________________________________________________ Phone: ____________________________________
The Above Named Applicant is Subming on Behalf of One of the Following:
HOA POA Other Organizaon of Authority
Organizaons Name: ________________________________________________________________________________
Rep Name: _______________________________________________________ Title: ____________________________
Mailing Address: ___________________________________________________________________________________
Email:_______________________________________________________ Phone: _______________________________
Meeng Venue Informaon
Space Available Y N Reserveable Y N Indoors Outdoors # of seats ________
Address: ________________________________________________Building Name: _______________________________
Contact Name: _____________________________________ Email: ____________________________________________
50% or more of the total number of homes must have a home Ignion Zoneassessment
completed on their home prior to moving forward with a live drill
60% or more of the home residents must sign a roster agreeing to support a live re drill within
their neighborhood
40% or more of the home residents must agree to have a household representave parcipate in
the live drill
Ocial Use Only
Signature: ________________________________________________________ Date: _________________________
TCSO_____ APD ______ Constable Pct.. ______ ESD ______ AFD _______ County. Pct. ______ City Council ______
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signature
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Explanation/Instructions
Neighborhood/Subdivision: Ocial name for the neighborhood/subdivision requesng a re drill.
Number of Homes: Total number of homes within the represented subdivision/neighborhood. This number is to include ALL
residences regardless of planned parcipaon in the drill.
Applicant Informaon: Name and contact informaon for the personlling out applicaon on behalf of the neighborhood.
Picking an Organizaon: Neighborhoodre evacuaon drills are required to be sponsored by a formal organizaon with rec-
ognized authority to represent the neighborhood/subdivision. Fire evacuaon drill planning and approval will normally be coor-
dinated through a Home Owners Associaon (HOA) or Property Owners Associaon (POA). It is recognized that there are
unique situaons, which might not fall within either of the two aforemenoned categories. Please select the box adjacent to
the category applicable to your neighborhood/subdivision and furnish the contact informaon for the appropriate posion of
authority for the applicable associaon/organizaon (i.e. President or Director of Board for HOA/POA).
Meeng Venue: There is a signicant amount of planning required to conduct a successful re evacuaon drill. Neighbor-
hood educaon outreach and planning meengs are an essenal component, which will be ulized to educate and disseminate
relevant informaon eecvely to the community. Several of these meengs will require a venue with space large enough to
accommodate the residents within the neighborhood who are interested in learning more and hopefully parcipang in the
future drill. Please provide the applicable informaon, if your neighborhood has a facility for meengs or access to a public
venue through a formal agreement.
Acknowledgments:
1) “60% or more of the home residents must sign a roster agreeing they are in support of their neighborhood conducting
a live-fire evacuation drill within their neighborhood”. The live-fire evacuation drill will potentially create traffic con-
gestion and other conditions which could potentially be perceived as disruptive. Buy-in from the residents of the
neighborhood is critical before moving forward with the large scale exercise. The designated neighborhood coordina-
tor will be required to circulate a roster throughout the neighborhood with a minimum of 60% of the households
within the subdivision indicating by signaturethat they support the neighborhood planning and conducting a live-
fire evacuation drill on a proposed date. Support for the drill does not indicate or obligate the resident to participate
in the drill. THE RESIDENCE SUPPORT ROSTER WILL BE REQUIRED TO BE COMPLETED WITHIN 30 CALENDAR DAYS OF
APPLICATION.
2) “At least 40% or more of the households must agree to have a household representative participate in the live drill.
Participation by at least 40% provides for a strong foundation of experience and knowledge within your community in
the event an evacuation is needed. While 100% of participation is encouraged, it is unrealistic due to a number of un-
controllable reasons. A ROSTER CONFIRMING 40% MUST BE PROVIDED 30 DAYS PRIOR TO THE SCHEDULED DRILL
DATE.
3) “50% or more of the total number of homes are required to have had a Home Ignition Zoneassessment completed
on their home prior to moving forward with a live drill. The Home Ignition Zoneassessment will be conducted by
government employees at no charge to the residents within the neighborhood. It will require that the resident coordi-
nate an appointment with the department performing the assessment. The Home Ignition Zone site assessment on
average takes less than 30 minutes to complete. It is has been recognized by industry experts as one of the most use-
ful components of the wildfire mitigation program. Further information in regards to the planning and implementa-
tion schedule for this component will occur during the community meetings held within the neighborhood.
Signature and Date: All applicaons require a signature from the applicant. By providing a signature you arm the infor-
maon provided is accurate and complete.