i-INFO Registry

Cross Timbers Regional Communications

- Storm Shelter Registration -

Do not use the browser's "Back" button while filling out this registration form.
If you do, your information will be lost.

Please review your information below and make changes as needed.

*Indicates required field.

Information about the Storm Shelter:

	*Biz / Household:	* required field
	Building / Facility:
	*Street Address:	* required field
	Line 2:
	* City / Town:	* required field
	* State:	* required field
	* Zip Code:	* required field
	* Business Main Phone:	* required field

Information about the person completing the form:

	* Courtesy Title:	Field is required.
	* First Name:	Field is required.
	Preferred First Name:
	Middle Name:
	* Last Name:	Field is required.
	Business Phone:
	Mobile:
	* Home Phone:	Field is required.
	Business Email:
	* Home Email:	Field is required.

Detail about the storm shelter:

*Type of Shelter:	* required field.
If "Other", please describe below.
*Location of Shelter:	* required field.
If "Other", please describe below.
Storm Shelter Latitude (e.g. 33.549979):
Storm Shelter Longitude (e.g. -99.279327):

Additional Comments:

After completing the form, please submit your information to complete your registration.

*To submit your information, please enter the following validation code and click the 'Submit' button. Note: you will not lose any information if the validation code is entered incorrectly, but you will be asked to re-enter the code correctly to complete registration.

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