Fillable OFFICE OF CIVIL DEFENSE & FIRE COORDINATOR (County of Fulton)

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OFFICE OF CIVIL DEFENSE & FIRE COORDINATOR (County of Fulton)

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BROWSE COUNTY OF FULTON (NY) FORMS

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OFFICE OF
CIVIL DEFENSE & FIRE COORDINATOR
County Services Complex
2714 State Highway 29
Johnstown, New York 12095
Steven J Santa Maria TELEPHONE: Office: (518)736-5858
Civil Defense Director/Fire Coordinator FAX: (518)762-4938
INFORMATION NEEDED FOR ID TAGS
NAME ________________________
FIRE DEPT ________________________
TRAINING ID # ______________ (
IF KNOWN)
GENDER
RACE
HEIGHT
HAIR COLOR
WEIGHT
DATE OF BIRTH
BLOOD TYPE
EYE COLOR
EMERGENCY
COTACT NAME
EMERGENCY
CONTACT #
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OFFICE OF CIVIL DEFENSE & FIRE COORDINATOR (County of Fulton)

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Completed 6 August 2020

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