Cooling Center Registration

Organization Name *

Organization Type

Cooling Center Address *

Address Line 1

Address Line 2

City

State

Zip Code

Emergency – 24/7 Contact Number (Non-Public) *

24/7/365 number emergency management officials can call to reach a contact person about your cooling center.

Contact Name *

First

Last

Contact name of the person responsible for the cooling center.

Contact Position / Title *

E-Mail Address *

Public Contact Phone Number *

Public phone number that can be published for contacting your cooling center or cooling center contact.

Days of Operation

Please list the days of the week your cooling center will be made available to the public.

Hours of Operation *

Please list the hours of operation your cooling center will be made available to the public.

Starting Date *

Please list the starting date your cooling center will be made available to the public.

Ending Date *

Please list the final date your cooling center will be made available to the public.

Pet / Animal Friendly

Please list the guidelines your cooling center will utilize concerning animals/pets.

Comment or Message

Please include any additional information you would like concerning your cooling center.