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DETAILS:

PLATE#:

Reason:

MAKE:

MODEL:

VEHICLE COLOR:

STATE:

ADDRESS #:

DIRECTION:

STREET NAME:

SUITE/UNIT:

CITY:

STATE:

ZIP CODE:

START DATE:

END DATE:

Please enter the Actual Calendar Date you wish to park on the street.

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FIRST NAME:

LAST NAME:

PHONE #:

Email:

NOTES :

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PLATE#:

MAKE:

MODEL:

VEHICLE COLOR:

PLATE#:

MAKE:

MODEL:

VEHICLE COLOR:

PLATE#:

MAKE:

MODEL:

VEHICLE COLOR:

PLATE#:

MAKE:

MODEL:

VEHICLE COLOR:

By enrolling in the Special Needs Alert Program, you acknowledge and agree to the following:

Purpose of the Program

The Special Needs Alerts Program (SNAP) allows At-Risk Residents, individuals with disabilities, medical conditions, or special needs, to be voluntarily registered with the Ellis County Communications in partnership with the Ellis Police Department. This information helps first responders provide appropriate assistance during emergencies.

Voluntary Participation

Participation in this program is voluntary. By submitting information, you consent to the collection, storage, and use of the provided details by law enforcement and emergency personnel for response purpose.

Accuracy and Updates

It is the responsibility of the registrant or their legal guardian to ensure that the information remains current. Any updates, changes, or removals should be reported by emailing the Ellis County Communications (SNAP@ellisco.net) as soon as possible.
Periodic renewal may be required to ensure data accuracy.

Confidentiality and Data Use

Information submitted through this program is considered confidential and will only be used by authorized personnel for emergency response and law enforcement purposes.
This data will not be shared with third parties except as required by law or for emergency response coordination.

No Guarantee of Specific Response

Registration in this program does not guarantee any particular response, priority, or level of service in an emergency. First responders will make decisions based on the circumstances at the time of the incident.

Legal Disclaimer

Submission of false or misleading information may result in removal from the program and, in some cases, legal action.
The agency assumes no liability for the misuse of submitted information or for any actions taken in reliance on the information provided.
The participating agencies takes the security and privacy of your information seriously. However, no system is completely immune to breaches, and by enrolling, you accept this risk.

Opt-Out

You may choose to opt out of the program at any time by updating your registration profile. Upon withdrawal, your information will be removed from the program database.

I AGREE TO THE DISCLAIMER(Take me to the online form)

As a resident, you have the ability to request your own entries that will be directed right to your Law Enforcement Agency. Simply choose the selection below and fill out a form for your request.

This system is not continuously monitored.

If this is an emergency, please call 911

KEY HOLDER INFO:

ALARM INFO:

Comments:

Fort Hays State University Police Department

OVERNIGHT PARKING ENTRY

DETAILS:

OVERNIGHT PARKING

VACATION WATCH ENTRY

CONTACT INFO:

DETAILS:

VACATION WATCH

CONDITION REPORT ENTRY

DETAILS:

CITIZEN REPORTING

INCIDENT LOCATION:

PERSONAL CONTACT INFO:

INCIDENT INVOLVES A VEHICLE:

INCIDENT INVOLVES PROPERTY:

CITIZEN REPORTING

BIKE MANAGEMENT ENTRY

CONTACT INFO:

DETAILS:

PET MANAGEMENT

PET MANAGEMENT ENTRY

CONTACT INFO:

DETAILS:

PET MANAGEMENT

KEY HOLDER ENTRY

COMPANY INFO:

KEY HOLDER INFO:

ALARM INFO:

Key Holder Entry:

KEY HOLDER ENTRY

Residence Info:

KEY HOLDER INFO:

ALARM INFO:

Comments:

AT-RISK RESIDENTS ENTRY

PERSONAL CONTACT INFO:

EMERGENCY CONTACTS:

MEDICAL CONTACT INFORMATION:

ADDITIONAL DETAILS:

COMMENTS:

AT-Risk Residents

Purpose of the Program

Voluntary Participation

Accuracy and Updates

Confidentiality and Data Use

No Guarantee of Specific Response

Legal Disclaimer

Opt-Out

Fort Hays State University Police Department