UCPD



UCPD VIDEO SYSTEM

EMERGENCY CONTACT INFORMATION FOR AFTER-HOURS

Please provide COMPLETE contact information for those individuals in your department responsible for responding to the campus and meeting with UCPD after-hours.

Account No. DATE:

First Emergency Contact:

|LAST NAME: |FIRST NAME: |Title: |Campus Ext: |

| | |      | |

|      | |      |      |

| | | | |

| | | | |

| | | | |

| | |

|Campus Mailing Address: |      |

|Campus E-Mail Address: |      |

|Home telephone number: |      |

|Cellular telephone number: |      |

|Pager number: |      |

Second Emergency Contact:

|LAST NAME: |FIRST NAME: |Title: |Campus Ext: |

| | |      | |

|      |      |      |      |

| | |

|Campus Mailing Address: |      |

|Campus E-Mail Address: |      |

|Home telephone number: |      |

|Cellular telephone number: |      |

|Pager number: |      |

Third Emergency Contact:

|LAST NAME: |FIRST NAME: |Title: |Campus Ext: |

| | |      | |

|      |      |      |      |

| | |

|Campus Mailing Address: |      |

|Campus E-Mail Address: |      |

|Home telephone number: |      |

|Cellular telephone number: |      |

|Pager number: |      |

Please return completed form to:

UCPD – Crime Prevention Unit

36 Sproul Hall

MC 1199

Berkeley, CA 94720

(or E-mail to: UCPDvideoandalarm@berkeley.edu)

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