Severe Weather Center 9 Closings System

All fields required except where indicated (optional)

Do you currently have a Severe Weather Center 9 PIN and password?

• Yes
• No

Current PIN:  (optional)

Current password:  (optional)

Name of organization:

Mailing address:

City:

State:

ZIP code:

Contact person:

Title:  (optional)

Primary phone number:

Backup phone number (typically home or cell):

E-Mail:

Confirm e-mail:

Select the category that best describes your organization:

SchoolChurchBusinessDay careMedicalGovernmentCommunity organization

Number of employees:

• 0-5
• 5-10
• 10-30
• 30-50
• 50-100
• 100-200
• 200-500
• 500+

Average number of customers/persons affected by closing:

Comments:

I acknowledge that I may be contacted by WSOC-TV regarding my submission.  (optional)