SafeOregon Tip Line Enrollment Form
Use this online enrollment form if you need to sign-up a single school for the SafeOregon Tip Line. If you are signing up multiple schools or multiple contacts at the same time, you may find it helpful to use the enrollment spreadsheet, so that you may copy and paste duplicate addresses or other duplicate information more easily. If you would prefer to use the enrollment spreadsheet, please send a request to support@safeoregon.com. A team member will send a reply with the enrollment spreadsheet.
County Name
(Please list what county out of the 36 counties in Oregon your school resides.)
Your answer
School District Name
(Helps us understand where your school fits in the State structure.)
Your answer
District Contact Role and First Name and Last Name (ex. Superintendent Jane Johnson)
(We may contact to validate a change with a sign-up request.)
Your answer
District Contact Phone Number (xxx-xxx-xxxx)
(We may contact to validate a change with a sign-up request.)
Your answer
District Contact Email Address
(We may contact to validate a change with a sign-up request.)
Your answer
School Name
(An individual school name)
Your answer
Approximate # of students at this school
(A close estimate is all we need.)
Your answer
Street Address where the school can accept packages
(If your school has more than one address (various building locations), include all. This address must be able to accept packages.)
Your answer
School City
(If your school has more than one address (various building locations), include all. This address must be able to accept packages.)
Your answer
School Zip Code
(If your school has more than one address (various building locations), include all. This address must be able to accept packages.)
Your answer
School Primary Contact Role and First Name and Last Name (ex. Principal Julie Thomson)
(This is a key role to receive tips and act on them on behalf of the school.)
Your answer
School Primary Contact Phone Number (xxx-xxx-xxxx) This number should be accessible 24/7
(If a critical or urgent tip comes in 24/7, we will use this number to reach the primary contact.)
Your answer
School Primary Contact Email Address
(Tips will come to this e-mail address.)
Your answer
School Secondary Contact Role and First Name and Last Name (ex. AsstPrincipal Paul Jackson)
(This is a back-up role to the primary contact.)
Your answer
School Secondary Contact Phone Number (xxx-xxx-xxxx) This number should be accessible 24/7
(If a critical or urgent tip comes in 24/7, we will use this number to reach the secondary contact if the primary contact does not respond.)
Your answer
School Secondary Contact Email Address
(Tips will come to this e-mail address just as they would for the primary contact.)
Your answer
Optional School Third Contact Role and First Name and Last Name (ex. Counselor Jeff Anderson)
(Choice to add an extra contact to receive tips. If more are needed, just contact us.)
Your answer
Optional School Third Contact Phone Number (xxx-xxx-xxxx) This number should be accessible 24/7
(Choice to add an extra contact to receive tips. If more are needed, just contact us.)
Your answer
Optional School Third Contact Email Address
(Choice to add an extra contact to receive tips. If more are needed, just contact us.)
Your answer
Primary 9-1-1 Center 10-digit telephone number
View our 9-1-1 page for assistance. http://safeoregon.com/9-1-1-information. By entering this information you certify that it is true and accurate and is the 24 hour 10-digit local number for your schools to connect to your local emergency line for your 9-1-1 Center. Important: do not list the business number for your 9-1-1 Center.
Your answer
What is the name of the 9-1-1 center for your school?
Your answer
What is the address of the 9-1-1 Center for your school?
Your answer
Secondary 9-1-1 Center 10-digit telephone number
View our 9-1-1 page for assistance. http://safeoregon.com/9-1-1-information. By entering this information you certify that it is true and accurate and is the 24 hour 10-digit local number for your schools to connect to your local emergency line for your 9-1-1 Center. Important: do not list the business number for your 9-1-1 Center.
Your answer
What is the name of the secondary 9-1-1 center for your school?
Your answer
What is the address of the secondary 9-1-1 center for your school?
Your answer
Name and phone number of person completing this form?
Your answer
Next Steps
Once you press submit you will receive a confirmation message and be able to enter another school.
Submit
Never submit passwords through Google Forms.
This form was created inside of Sprigeo. Report Abuse - Terms of Service - Additional Terms