Alert Sign Up Form
Ness County has a new alert system that will call your home phone, cell phone, send a text
message and also emails when there is a threat to life or property. For people who can't hear the
sirens in our towns and those who live in rural areas this could be a life saver



Contact information:



Home Phone Number 1 _________________                       Text Message Phone 1 ____      

Work Phone Number 2 _________________                        Text Message Phone 2____

Cell Phone Number 3   __________________                       Text Message Phone 3____

Email:________________________________

Email:________________________________



User Information:                                                                       Town: _________

Parents First Name: __________________                          Township: ___________   

Parents Last Name:___________________                       

Middle Initial:_____ ______                                              

Address 1:__________________________                         

Address 2:__________________________                            

City:_______________________________                        

State:______________________________   
                     
Zip:________________________________                            




Email Form to:  
 nessecodevo@gbta.net