StormReady Application Form

Department of Commerce
National Oceanic &
Atmospheric Administration
National Weather Service

Application Form
OMB Control #0648-0419
Expires 06/30/2006

NOTE: Please contact the Warning Coordination Meteorologist (WCM) at your local National Weather Service Forecast Office (WFO) prior to submitting this application at: http://www.stormready.noaa.gov/contact.htm. This will ensure the correct WFO indentifier and that the application had been configured for use at the local WFO. To identify the proper WFO ID click on "WFO" here or below left.

Community Information
WFO		County		City/Town		Population

Primary Point of Contact			Secondary Point of Contact
Name			Name
Office			Office
Title			Title
Mailing Address			Mailing Address
City			City
State			State
ZIP			ZIP
Phone			Phone
e-mail			e-mail

Communications
Location of 24 Hour Warning Point			Location of Emergency Operations Center

Renewal Comments:	Date:	Initials:

NWS Information Reception Equipment

Warning Point #Required______ #Verif______
EOC #Required______ #Verif______

NOAA Weather Radio (Required if in range)

NOAA Weather Radio (Required if in range)

NOAA Weather Wire (Subscription)

NOAA Weather Wire (Subscription)

EMWIN

EMWIN

Law Enforcement Teletype (LETS)

Law Enforcement Teletype (LETS)

Amateur Radio

Amateur Radio

Pagers* (Warning reception)

Pagers* (Warning reception)

Television (Local network or cable TV)

Television (Local network or cable TV)

Radio (AM/FM) - EAS reception

Radio (AM/FM) - EAS reception

NAWAS

NAWAS

Internet (Subscription for alerts):

Internet (Subscription for alerts):

Commericial Data Service:

Commericial Data Service:

Other*

Other*

Other*

Other*

*Capabilities needing explanation:

Renewal Comments: Date: Initials:

Local Weather & Water Monitoring Equipment

Warning Point #Required______ #Verif______ EOC #Required______ #Verif______

Anemometer (Wind gauge)

Anemometer (Wind gauge)

Rain Gauge

Rain Gauge

River Gauge

River Gauge

Locally owned Radar

Locally owned Radar

Internet Radar Source:

Internet Radar Source:

Internet Weather Station:

Internet Weather Station:

TV Radar Source:

TV Radar Source:

Other*

Other*

Other*

Other*

*Capabilities needing explanation:

Renewal Comments: Date: Initials:

Local Warning Dissemination

Warning Point #Required______ #Verif______ EOC #Required______ #Verif______

Outdoor Warning Siren(s)

Outdoor Warning Siren(s)

Cable TV Override

Cable TV Override

Plan for Sirens on Emergency Vehicles

Plan for Sirens on Emergency Vehicles

Telephone Tree for Criticial Facilities

Telephone Tree for Criticial Facilities

Local Alert Broadcast System*

Local Alert Broadcast System*

Local Pager System* (dissemination)

Local Pager System* (dissemination)

Coordinated Area-Wide Radio Network*

Coordinated Area-Wide Radio Network*

Local Flood Warning System*

Local Flood Warning System*

Other*

Other*

Other*

Other*

*Capabilities needing explanation:

Renewal Comments: Date: Initials:

Local Government Owned Buildings with Public Access

Office Location or Address Tone Alert NOAA
Weather Radio Comments

Warning Point

EOC

City Hall

School Superintendent

Renewal Comments: Date: Initials:

Community Preparedness

Annual Safety Talks #Required______ #Verif______

Date Topic Location Speaker

1

2

3

4

5

Weather Radio Purchase Program
Has your community/county developed a program to subsidize the purchase of Specific Area Message Encoder (SAME) equipped Weather Radios for its citizens? (not required) Yes No

If yes, provide details:

Other Community Preparedness Activities

Date Topic Location Organizer

1

2

3

4

5

Renewal Comments: Date: Initials:

Administrative Tools/Record Keeping Renewal

Formal Hazardous Weather Operations Plan Yes Yes

Procedure for reporting storm/tsunami damage to the local National Weather Service Office in real-time
Yes Yes

EOC Activation Procedures
Yes Yes

Spotter Activation Criteria
Yes Yes

Local Warning System(s) Activation Criteria
Yes Yes

Warning Point personnel has authority to activate Warning System (written) Yes Yes

Spotter Roster and Training Record Yes Yes

Last Visit by Emergency Manager to NWS Office Date: Date:

Last Visit by NWS Officials to Community Date: Date:

Last NWS Spotter Training for Spotters and Dispatchers Date: Date:

Last NWS Spotter Training Hosted/Co-Hosted (For populations >40,000) Date: Date:

Exercises (topics): Date: Date:

Renewal Comments: Date: Initials:

Additional Information

List any additional descriptions, narratives, or documentation below. If the information applies to a specific part of the form, please indicate which part.

Applying Official

Application Submitted by: Date:

Office: Title:

On submission of your application, the National Weather Service Office (WFO) you selected will be notified and your form sent to them. Also, you will be given the opportunity to print out your application to keep for your records.

NWS Information Reception Equipment
	Warning Point #Required______ #Verif______	EOC #Required______ #Verif______
	NOAA Weather Radio (Required if in range)	NOAA Weather Radio (Required if in range)
	NOAA Weather Wire (Subscription)	NOAA Weather Wire (Subscription)
	EMWIN	EMWIN
	Law Enforcement Teletype (LETS)	Law Enforcement Teletype (LETS)
	Amateur Radio	Amateur Radio
	Pagers* (Warning reception)	Pagers* (Warning reception)
	Television (Local network or cable TV)	Television (Local network or cable TV)
	Radio (AM/FM) - EAS reception	Radio (AM/FM) - EAS reception
	NAWAS	NAWAS
	Internet (Subscription for alerts):	Internet (Subscription for alerts):
	Commericial Data Service:	Commericial Data Service:
	Other*	Other*
	Other*	Other*
*Capabilities needing explanation:

Local Warning Dissemination
	Warning Point #Required______ #Verif______	EOC #Required______ #Verif______
	Outdoor Warning Siren(s)	Outdoor Warning Siren(s)
	Cable TV Override	Cable TV Override
	Plan for Sirens on Emergency Vehicles	Plan for Sirens on Emergency Vehicles
	Telephone Tree for Criticial Facilities	Telephone Tree for Criticial Facilities
	Local Alert Broadcast System*	Local Alert Broadcast System*
	Local Pager System* (dissemination)	Local Pager System* (dissemination)
	Coordinated Area-Wide Radio Network*	Coordinated Area-Wide Radio Network*
	Local Flood Warning System*	Local Flood Warning System*
	Other*	Other*
	Other*	Other*
*Capabilities needing explanation:

Local Government Owned Buildings with Public Access
Office	Location or Address	Tone Alert NOAA Weather Radio	Comments
Warning Point
EOC
City Hall
School Superintendent

Community Preparedness
Annual Safety Talks #Required______ #Verif______
Date	Topic	Location	Speaker
1
2
3
4
5

Weather Radio Purchase Program
Has your community/county developed a program to subsidize the purchase of Specific Area Message Encoder (SAME) equipped Weather Radios for its citizens? (not required)	Yes No
If yes, provide details:

Other Community Preparedness Activities
Date	Topic	Location	Organizer
1
2
3
4
5

Administrative Tools/Record Keeping		Renewal
Formal Hazardous Weather Operations Plan	Yes	Yes
Procedure for reporting storm/tsunami damage to the local National Weather Service Office in real-time	Yes	Yes
EOC Activation Procedures	Yes	Yes
Spotter Activation Criteria	Yes	Yes
Local Warning System(s) Activation Criteria	Yes	Yes
Warning Point personnel has authority to activate Warning System (written)	Yes	Yes
Spotter Roster and Training Record	Yes	Yes
Last Visit by Emergency Manager to NWS Office	Date:	Date:
Last Visit by NWS Officials to Community	Date:	Date:
Last NWS Spotter Training for Spotters and Dispatchers	Date:	Date:
Last NWS Spotter Training Hosted/Co-Hosted (For populations >40,000)	Date:	Date:
Exercises (topics):	Date:	Date:

Applying Official
Application Submitted by:	Date:
Office:	Title:


On submission of your application, the National Weather Service Office (WFO) you selected will be notified and your form sent to them. Also, you will be given the opportunity to print out your application to keep for your records.