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2. 
3. AUTHORIZATION TO SEND EMERGENCY DISPATCH TEXT MESSAGES
   By signing below I authorize Onslow County Emergency Services, Communications Division (herinafter collectively referred to as Onslow County Communications), to send a text message to the below identified cell phone each time the designated agency is dispatched to an emergency call.
   
   This form MUST be signed by the chief officer of your Department and returned to Onslow County Communications for activation.
   
   Fax form to: 910-455-6767
   Email form to: whitney_davis@onslowcountync.gov
   Drop off at: 1180 Commons Dr. N, Jacksonville
5. Cell Phone Service Carrier*
6. Cell Phone Number*
7. Agency Representing:*
9. Futher, I understand:
   1. This is voluntary on my part, and that I must provide Onslow County Communications with written notification of my desire to no longer receive such text messages, and that Onslow County Communications has 10 working days after receipt of such notification to remove my name and number from the text message list.
   
   2. I am authorized to use this cell phone for the purposes stated herein.
   
   3. I am solely responsible for all costs, including but not limited to fees/charges/taxes, that my cell phone service carrier charges to my phone as a result of the text message from Onslow County Communications.
   
   4. This is not a primary means of dispatch to emergency calls, and that Onslow County Communications has provided no guarantee on the delivery of the text message nor the timeliness of their receipt.
   
   5. That, pursuant to North Carolina General Statutes, Chapter 132, text messaging to and from Onslow County Emergency Services may be considered a public record under the North Carolina Public Records Law and may possibly be disclosed to third parties.
11. Printed Name:*
12. Date*
    Date
14. Signature:
16. Chief Officer
    I, being the Officer of the below indicated Agency, verify that the above individual is a member of the indicated Agency. As such, they are approved to receive text messages concerning dispatches for said Agency.
18. Printed Name:*
19. Title:*
20. Date:*
    Date:
22. Signature of Chief Officer:
24. YOU MUST PRINT THIS FORM OFF AND HAVE IT SIGNED BY THE CHIEF OFFICER OF YOUR AGENCY
Leave This Blank:


25. Print Only

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