1.Please answer yes or no to each of the statements below.

Yes

No

I have placed a sturdy pair of shoes under my bed to protect my feet if an earthquake takes place at night.

Yes

No

I have emergency supplies in my car.

Yes

No

I have included prescription medicines in my emergency supplies.

Yes

No

I have included copies of my important documents, including insurance information, in my emergency supplies.

Yes

No

Each member of my family has the phone number of our “Out of State Emergency Contact” in case we cannot reach each other with a local phone call during a disaster.

Yes

No

I have stored supplies of food and water for each member of my family, including my pets, to sustain us after a disaster.

Yes

No

I have signed up for Kitsap Emergency Management’s Alert and Warning notifications at http://www.kitsapdem.org/

Yes

No

I have signed up for inclement weather and road report updates from Kitsap County http://www.kitsapgov.com/

Yes

No

We want to help you get prepared.
The first 50 people to take the survey are eligible to receive a hand-cranked flashlight to add to their preparedness kit.
If you would like to receive the flashlight please enter your mailing information below.
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2.Address

Name

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address