Sun City Shalom Club

Emergency Form

Dear Shalom Club Member:

The Shalom Club Board is developing a confidential listing for members who desire to have the club maintain a personal contact for its members in case of an Emergency.  It should be a person at an address other than your own, and might be a friend, neighbor, relative or any other person you would want contacted should there be an Emergency

The Confidential List will be maintained by the Corresponding Secretary for the Chair of the Good and Welfare Committee.

The reason for developing the list is because there have been a number of emergencies in Sun City (thank goodness none of those have involved our members) and in some cases the community did not know who to reach so the only contact was a government agency.  In the case of the list we are compiling, the contact would only be made if there were no other choice.

If you would like to participate, simply send the following information to Phil Wizwer, Co-President:  80 Herons Bill Drive.

YOUR NAME:  _______________________________________________


PERSON TO BE CONTACTED: __________________________________


RELATIONSHIP: ______________________________________________
(Please Specify:  Son, Daughter, Grandchild, Friend, Neighbor, etc.)


CONTACT'S ADDRESS:________________________________________
                       
                       
                                  ________________________________________


CONTACT'S TELEPHONE NUMBER: ______________________________


CONTACT'S E-MAIL ADDRESS______________________________________


                       DATE:_______________________________________


                       SIGNATURE_________________________________

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