Rich Square, NC · Northampton County
Early Transport List for Storm Emergencies
Rich Square residents with impaired mobility or a medical condition use this form to request early transport to the town storm shelter during weather emergencies.
What this form is
This form lets Rich Square residents request early transport to the Rich Square Storm Shelter at the WS Creecy Gym because of impaired mobility or a medical condition. It asks for contact details, medical or mobility information, special needs or equipment, and a caretaker or contact person. The town shares the information with the Rich Square Volunteer Fire Department and the shelter to help coordinate an emergency response.
Who needs it
Rich Square residents who need early storm-emergency transport because of impaired mobility or a medical condition should complete this form.
How to submit it
Return the completed form to Town Hall or email it to [email protected].
About notarization
This document is signed without a notary; the signer just completes the requested information, signs, and dates it.
How to submit this form
- 1
Download The Form
Download the Early Transport List for Storm Emergencies PDF.
- 2
Complete The Form
Provide your contact details, medical condition or impairment, special needs or equipment, and caretaker or contact person information.
- 3
Review Your Information
Check that the requested contact and needs information is complete.
- 4
Submit To The Town
Return the completed form to Town Hall or email it to [email protected].
Frequently asked questions
- Do I need a notary for the Early Transport List?
- No. This form does not require a notary; the signer just completes the requested information, signs, and dates it.
- Who should complete this form?
- Rich Square residents who require early transport to the town storm shelter because of impaired mobility or a medical condition should complete it.
- How do I submit the Early Transport List?
- Return the completed form to Town Hall or email it to [email protected].