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* 1. Name

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* 2. Address

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* 3. Do you live in a neighborhood that has gone through the Map Your Neighborhood (MYN) planning process?

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* 4. Do you have a 14 day supply of food, water, prescriptions, and other essentials (for all members of your household and pets) in your emergency kit?

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* 5. Do you have a first aid kit under or near your bed, in your vehicles, and go bag?

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* 6. Do you have a hard hat, gloves, sturdy shoes, emergency radio, and a flashlight under or near your bed?

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* 7. Do you know where your utility shut offs are located at home and have and any needed tools to shut them off?

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* 8. Do you have any questions or comments regarding emergency preparedness that the Emergency Preparedness Committee may assist with?

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