Home Page Our Association Our Community Resources Contacts Our Pets Photo Album

JOIN OUR ASSOCIATION

We currently have a roster of over 400 households that have joined our association. We have been able to share important information with these neighbors quickly through e-mails and telephone. We want to get all of our neighbors on our roster and mailing lists to make sure we have a way to stay in contact with each other.

This is truly a situation where we have 'strength in numbers' ...! The LAFD tells us that in the aftermath of a major disaster, we're on our own for 3 to 7 days - so knowing who is where and what help is available or needed is critical.

If you live within the boundaries of our association (see map), SIGN UP HERE TO BE ADDED TO OUR EMERGENCY ROSTER AND MAILING LISTS. And if you are interested in pitching in, tell us that, too!

You can fill out the form below online. You can also print out the PDF Form, fill it out, and return it to us via FAX to 323-851-4570.

The information you provide to us is for emergency use only and will be kept confidential by the Association Chairs and Block Captains. The information will only be used in time of emergency by your block captains or given to first responders should there be a critical need to evacuate or check on residents. We will stay in contact with you via neighborhood updates to the email address you provide (or mailbox drops if you do not use email). Your contact information will never be used for commercial, political, or charitable purposes.

Your First Name Last Name Home Phone Work Phone Cell Phone E-mail Address
Other Residents' First Name Last Name Home Phone Work Phone Cell Phone E-mail Address

Street Address
Number of Occupants Adults and Children and Pets and Other

Do you have a Security Company?
No Yes

Does anyone have a disability or need assistance in an emergency?
Does anyone not understand English?
If 'yes', what language?		 No Yes

Emergency Contact (different from residents)
Gas Shut-off Location
Additional Information, Comments and Suggestions
Please have my Block Captain contact me now No need ... By Phone ... By E-mail
 
Terms of Use • Privacy Policies Monday, February 6, 2012
©2012 Upper Nichols Canyon Neighborhood Association
Site Design • iNet // Web Solutions
8a9b46288f35a2b777e9fc00f7dc62f3
120206NC647714