Form FEMA Form 089-17 FEMA Form 089-17 RCPT Membership List

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Overview

Requirements
RCPT Membership List

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Sheet 1: Requirements

Requirements for RCPT Membership List

The RCPT Membership List must be updated as appropriate and submitted as part of the FY 2009 Grant Application Package. As with the FY 2008 grant cycle, all jurisdictions that comprise the defined RCPGP site must be directly or indirectly represented in the RCPT. Direct representation refers to the inclusion of government personnel from the associated jurisdiction, whereas indirect representation refers to the inclusion of representatives from outside of the jurisdiction that have been granted the authority to represent the jurisdiction. Indirect representation must be clearly delineated. Additionally, a jurisdictional or SME representative may fulfill more than one capacity/ requirement.

At a minimum, each RCPGP site must include direct or indirect representation from each of the jurisdictions that comprised the site footprint in the FY 2008 grant cycle. Each RCPGP site is not limited to the specified group of jurisdictions, and can incorporate additional jurisdictions, as the UAWG and RCPT deem appropriate. A map of each RCPGP site and a list of included jurisdictions can be found in Appendix B of the FY 2009 Guidance and Application Kit.

SME Representation to RCPT

Required RCPT Representation

• Representatives from appropriate State and local agencies and organizations • Tribal and regional representatives • Critical Infrastructure owners and operators • Representatives from contiguous jurisdictions • Mutual aid partners

• Local Metropolitan Medical Response System (MMRS) representatives • Private sector representatives • Citizen Corps Council representatives • Local and State Homeland Security and Emergency Management Agency representatives

Recommended RCPT Representation

• Fire representatives • Hazmat representatives • Medical representatives • Environmental representatives

• Law enforcement representatives • Public Health representative • Other representatives, as appropriate

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Sheet 2: RCPT Membership List

OMB Control Number: 1660-NEW
					FEMA Form Number: 089-17
Expiration Date: XX/XX/XXXX
Paperwork Burden Disclosure Notice
Public reporting burden for this form is estimated to average 0.2 hour per response. The burden estimate includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and submitting the form. You are not required to respond to this collection of information unless it displays a valid OMB control number. Send comments regarding the accuracy of the burden estimate and any suggestions for reducing the burden to: Information Collections Management, Department of Homeland Security, Federal Emergency Management Agency, 500 C Street, SW, Washington, DC 20472, Paperwork Reduction Project (1660-NEW) NOTE: Do not send your completed form to this address.
[Enter Site Name] RCPT Membership List
Name	Agency	Professional Title	Jurisdiction(s) Represented	Discipline(s) Represented/ Functional Expertise	Role on RCPT	E-mail (optional)