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Partners in Preparedness: Reporting Tool
Welcome to the Partners in Preparedness Program! Please complete the follow survey about your organization's activities to validate your status as a Partner and to allow the Office of Emergency Management to better support your efforts.
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1
. Organization and contact person information:
Organization and contact person information:
Name:
Company:
Address:
Address 2:
City/Town:
State:
-- select state --
AL Alabama
AK Alaska
AS American Samoa
AZ Arizona
AR Arkansas
CA California
CO Colorado
CT Connecticut
DE Delaware
DC District of Columbia
FM Federated States of Micronesia
FL Florida
GA Georgia
GU Guam
HI Hawaii
ID Idaho
IL Illinois
IN Indiana
IA Iowa
KS Kansas
KY Kentucky
LA Louisiana
ME Maine
MH Marshall Islands
MD Maryland
MA Massachusetts
MI Michigan
MN Minnesota
MS Mississippi
MO Missouri
MT Montana
NE Nebraska
NV Nevada
NH New Hampshire
NJ New Jersey
NM New Mexico
NY New York
NC North Carolina
ND North Dakota
MP Northern Mariana Islands
OH Ohio
OK Oklahoma
OR Oregon
PW Palau
PA Pennsylvania
PR Puerto Rico
RI Rhode Island
SC South Carolina
SD South Dakota
TN Tennessee
TX Texas
UT Utah
VT Vermont
VI Virgin Islands
VA Virginia
WA Washington
WV West Virginia
WI Wisconsin
WY Wyoming
ZIP:
Country:
Email Address:
Phone Number:
2
. Number of Employees in New York City:
Number of Employees in New York City:
1 - 9
10 - 49
50 - 149
150 - 299
300 - 499
500 - 999
1,000 - 2,500
Over 2,500
3
. Number of Volunteers in New York City:
Number of Volunteers in New York City:
Not Applicable
1 - 9
10 - 49
50 - 149
150 - 299
300 - 499
500 - 999
1,000 - 2,500
Over 2,500
4
. Has your organization completed required Activity One: Encourage your co‐workers and volunteers to register for Notify NYC, the City’s free real‐time emergency notification system?
Has your organization completed required Activity One: Encourage your co‐workers and volunteers to register for Notify NYC, the City’s free real‐time emergency notification system?
Yes
No
5
. Has your organization completed required Activity Two: Distribute and test your organization’s emergency contact plan?
Has your organization completed required Activity Two: Distribute and test your organization’s emergency contact plan?
Yes
No
6
. Has your organization completed required Activity Three: During September, distribute OEM’s weekly preparedness messages throughout your organization via Outlook, Facebook, Twitter (#npm), or your website? If this is before September do you plan to complete Activity Three?
Has your organization completed required Activity Three: During September, distribute OEM’s weekly preparedness messages throughout your organization via Outlook, Facebook, Twitter (#npm), or your website? If this is before September do you plan to complete Activity Three?
Yes
No
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7
. From the list below, which two activities has your organization completed?
From the list below, which two activities has your organization completed?
Host a preparedness display, including a sample Go Bag, Ready New York guides, and NYC Citizen Corps Council volunteer guide
Schedule a Ready New York presentation
Schedule/conduct a fire drill
Distribute Ready New York guides and Emergency Reference Cards to your staff
Schedule a work-from-home day or other method to test your business continuity practices
Mentor a smaller business or organization, or be mentored
Schedule a blood drive or CPR training for your organization
Encourage your employees to sign up for OEM's Tip of the Week or distribute Tip of the Week e-mails through your organization's intranet or newsletter
Other: Create and implement your own preparedness activity. OEM will recognize the most creative initiatives
Other (please specify)
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8
. Does your organization need additional materials to support your activities?
Does your organization need additional materials to support your activities?
Yes
No
If yes, please specify
Thank you for becoming a Partner in Preparedness! If you would like materials to distribute, or have questions or concerns, please emails us at publicprivate@oem.nyc.gov.
Thank you!
The Public/Private Team
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