PCEMS Standby Request Form
Please complete this form when requesting a Safety Standby from PCEMS. Please call 252-335-1524 if you need further assistance. Rates for standby coverages can be found at https://www.pasquotankcamdenems.com/billing .
Today's Date *
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Event Name *
Event Date *
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Event Begin Time *
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Event End Time *
Time
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Event Location (Please include street address) *
Event Point of Contact Person *
Contact Telephone Number *
Contact Email Address *
Event Request Type *
Please Provide a Brief Event Summary *
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