RSAN Application Form
 (Roam Alert Secure Network)
Note: Use of this form requires an e-mail client such as Outlook, Outlook Express, etc.

This system is administered by the Montgomery County, PA Department of Public Safety and is not intended for public use. It is for Emergency Responders ONLY.

MCDPS uses the Roam Secure Alert Network (RSAN) to immediately contact you during a major crisis or emergency. The RSAN delivers important emergency alerts, notifications and updates to you on all your devices:

  • E-mail Account (work, home, other)
  • Cell Phone (via SMS)
  • Pager
  • Smartphone/PDA (BlackBerry, Treo & and other handhelds)

When an incident or emergency occurs, authorized senders will instantly notify you using this RSAN. It is your personal connection to real-time updates, instructions on where to go, what to do, or what not to do, who to contact and other important information.

First Name:        Last Name:

E-mail Address:

MCVFPA Membership Number: * required        [Nonmembers click here]

You can select up to 3 devices for notification.

Alert Device 1:

Alert Destination Identifier 1:
(Alert Identifier typically a cell phone or Nextel number, or an e-mail address)

Alert Device 2:

Alert Destination Identifier 2:
(Alert Identifier typically a cell phone or Nextel number, or an e-mail address)

Alert Device 3:

Alert Destination Identifier 3:
(Alert Identifier typically a cell phone or Nextel number, or an e-mail address)

Additional Informational (optional)

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