TsunamiReady Supporter Application

Department of Commerce
National Oceanic & Atmospheric Administration
National Weather Service

2024 Supporter
Application Form
OMB Control 0648-0419
Expires XX/XX/20XX

TsunamiReady® Supporter Application
Community Contact Information
Applicant Entity
Name:

Peak # Occupants

Primary Point of Contact

Secondary Point of Contact

Name

Name

Office

Office

Title

Title

Mailing
Address

Mailing
Address

City

City

State, ZIP

State, ZIP

Phone

Phone

Email

Email

Location of Communications Center
(if applicable):
Notes:

Please do not write in shaded areas.

Public reporting burden for this collection of information is estimated to average two hours per response, including the time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the
collection of information. Send comments regarding this burden estimate or any other suggestions for reducing this burden to
[email protected].
Statement on confidentiality: Notwithstanding any other provisions of the law, no person is required to respond to, nor shall any person
be subjected to a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction
Act, unless that collection of information displays a currently valid OMB Control Number.

TsunamiReady® Application

1

Department of Commerce
National Oceanic & Atmospheric Administration
National Weather Service

2024 Supporter
Application Form
OMB Control 0648-0419
Expires XX/XX/20XX

TsunamiReady Supporter Criteria*
(Check all that apply)
*For more information about these criteria refer to the “TsunamiReady Supporter Information”
available at
http://www.tsunamiready.noaa.gov/supporters.shtml
1. Have ways to receive
tsunami messages (at
least two, one should
include warnings,
advisories, and watches)

NOAA Weather Radio

Others (list below)

Verified

Others (list below)

Verified

Others (list below)

Verified

Others (list below)

Verified

Others (list below)

Verified

TV/Cable
Radio
Private Providers
Wireless Emergency Alerts (warnings only)
Email/text notifications
Hours messages monitored
(at least when entity is occupied)

2. Have ways to
communicate tsunami
messages (at least two,
should include warnings
and advisories)

Public address
Sirens
Email/text notifications
Phone
Door-to-Door
Hours messages monitored
(at least when entity is occupied)

3. Make Tsunami Hazard
or Evacuation Zone
Map Available

Posted in central location
(at least one per occupied building)
Posted throughout entity
Distributed
Available online (e.g., intranet or website)
Date of most current map:
Map provider

4. Conduct Tsunami
Awareness and
Preparedness
Activities for:
Staff
Residents
Visitors
Others (list)
TsunamiReady® Application

Annual major outreach/education activity
(at least one, should include staff)
Other outreach/education activities
Drills and exercises
Tsunami evacuation drill
Participate in community tsunami exercise

2

Department of Commerce
National Oceanic & Atmospheric Administration
National Weather Service

5. Have Tsunami
Response Plan with
Evacuation
Instructions

2024 Supporter
Application Form
OMB Control 0648-0419
Expires XX/XX/20XX

Print copy available

Others (list below)

Verified

Electronic copy available
Print copy posted in common area

Describe additional activities entity does to support TsunamiReady program goals:

Signature of Applying Official
I acknowledge that this baseline TsunamiReady recognition does not indicate that our community has identified and/or
provided reasonable access to high-ground or safe refuge for all populations. I have discussed this with the National
Weather Service Verifier and my State/Territory Emergency Manager (or similar position).
Name of Applying Entity
Name of Applying Official

Title

Signature

Date

NWS Personnel Receiving
Application (print name)

Date
Received

NWS Approver Signature
NWS Office
Print Name

Title

Signature

Date

NWS Signature in Renewal Year
Name of Renewing Official:

Title

NWS Office:
NWS Personnel Receiving
Renewal Request
(print name):

Date
Received

NWS Approver (print name)

Title

Signature:

Date

TsunamiReady® Application

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