Direct Notification Registration Form
U.S. ARMY FORT ORD BASE REALIGNMENT AND CLOSURE OFFICE
2012 PRESCRIBED BURN PROGRAM
DIRECT NOTIFICATION REGISTRATION FORM
Complete this form to receive direct notification
(a phone call, text, and/or e-mail message) that prescribed
burn could occur shortly (within a day or two), when the
prescribed burn is started, and again when the burn is complete.
The Army will not share your personal contact information.
Providing your address is optional; however, if your address is
provided, the Army will mail information about the 2013
Prescribed Burn Direct Notification Program.
(Please print clearly)
----------------------------------------------------------------
Date: ____________________________
Name: ____________________________
Mailing Address: ____________________________
________________________________________________________
____________________________
(include street address or PO Box, City, State and Zipcode)
Phone Number:____________________________
( ) Voicemail
( ) Text
( ) Voicemail and Text
Alternate Phone Number:____________________________
( ) Voicemail
( ) Text
( ) Voicemail and Text
(If you wish to be notified by phone there must be an
answering machine or voice mail on the phone or someone must be
available to receive the message. Do not provide phone numbers
that include an extension, or that connect to a voice menu system.)
Email Address: ____________________________
Alternate Email Address: ____________________________
Fill out this form and mail or fax to:
Base Realignment and Closure Field Office
Fort Ord Prescribed Burn Direct Notification Program
P.O. Box 5008
Monterey, CA 93944-5008
Fax: (831)393-9188
Call (831)393-1284 or toll free at 1-800-852-9699 if you
have any questions, or go to http://www.fortordcleanup.com
E-mail: Melissa.Broadston@us.army.mil
Call 242-7383 or toll free at 1-800-852-9699 if you have any questions, or
check the web site at www.fortordcleanup.com for up-to-date information.
Para obtener una copia en Espanol contacte (831) 393-1284
|