[FrontPage Save Results Component]

Your Name:
Email address:
Day Phone and Extention:
Evening or emergency phone with area code:
Position in Organization:
Submitting your Organization was Authorized by:
Their Position in Organization:
Day Phone and Extention:
Organization Name:
Organization Type:	Sheriff Department Police Department Other
Street Address:
City:
State:
Zip Code:
Phone with Area code:
Primary Email Address:
Organization Web Site Address:
Computer Operating System:	Windows 95 Windows 98 Windows NT Macintosh Other
Connection to the Internet Via:	Dialup through Phone ISDN Cable Modem T1 Other Unknown
Is this computer on a LAN (Networked to other local computers)?	Yes No unknown
Is this computer or your station manned 24 hours, 7 days a week?	Yes No
If "No", Fill in below Hours your station has someone on duty:

Contact Methods and Information List
Include here ALL methods by which your Organization is to be contacted
In the event of an Abduction Alert in your area

Contact Email addresses: Enter only one per line. Make Certain they are exact and complete.
Fax Number Contacts: Enter only one Fax Number per Line. Make certain that this number includes Area Code.
Pagers capable of receiving a phone number or Alert Code Number only. Include Area Code if necessary. (If a PIN is also required enter as number/PIN)
Pagers Capable of receiving Email Messages. Note: these pagers operate in a number of different manners. Additional information may be necessary.                        Information contact Name:              Phone: Email: