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911 Address form
Brule County South Dakota

Please fill out form, print it out and mail it to us.
 
Brule County Sheriff Department
Attn: 911
300 S. Courtland St., Ste 112
Chamberlain, SD 57325

In order to provide the best possible Emergency Services, please take a moment to fill out the following questionnaire:
  1. How many people reside at your reside?_____ name & ages______________________________________________________
    _________________________________________________________ _________________________________________________________
  2. Provide two different ways of getting to your reside(this applies to rural families only) _________________________________________________________
    _________________________________________________________
    _________________________________________________________
    _________________________________________________________
  3. List any special medical conditions you or a family member may have_____________________________________________________
    ________________________________________________________
    ________________________________________________________
  4. In the event of an emergency and you are not available, who may we  contact that does not live with you, name & phone number.
    ________________________________________________________
    ________________________________________________________
  5. Identify and provide locations of any hazardous materials you may store on your property. ________________________________________________________
    ________________________________________________________
  6. If you have a rural address, specify what ambulance service and fire department you prefer.
    ________________________________________________________
    ________________________________________________________
  7. Provide your complete address, phone number, and cell phone numbers.
    ________________________________________________________
    ________________________________________________________

NOTE: All information provided is strictly confidential! Your assistance is
              greatly appreciated.

Sincerely,
Brule County Sheriff Department

 

Call 911 for Emergency