Disaster Assistance Voluntary Registry
The Dane County Disaster Assistance Voluntary Registry has been developed in an effort to identify individuals who cannot safely evacuate their homes in the event of a disaster. Registration does not guarantee any particular emergency services or level of emergency services during a disaster. It will however enhance the ability of emergency management and local officials to meet the emergency needs of the community.
You might want to apply to be on the Disaster Preparedness Registry if you or someone you care for would:
- Need outside help to safely leave your home during a disaster
- Be in jeopardy if you had to stay in your home for three days, without assistance
- Need special notification about the need for evacuation, due to impairment
To Register
- Click on the form link below
- Print out the form
- Complete the form
- Send the completed form to the address listed below
Form
Disaster Assistance Voluntary Registry Form (Word Format)
Disaster Assistance Voluntary Registry Form (PDF Format)
Address
Dane County Emergency Management
Room 2107 Public Safety Building
115 West Doty Street
Madison, WI 53703-3202
Other Information
Contact Information
If you have any questions please contact:
Dane County Emergency Management
Room 2107 Public Safety Building
115 West Doty Street
Madison, WI 53703-3202
Phone: (608) 266-4330
Fax: (608) 266-4500
TTY: (608) 267-1597
Email: maly@co.dane.wi.us