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Preparedness

Please complete the form below to request a presenter from Emergency Management at your function or event.  If you have any questions please call the main office at 321-637-6670. 


Requestor's Information

First Name: *
Last Name: *
Email Address: *
Phone Number: *
Department/Agency:
Organization/Affiliation:

Presentation Information

Requested Topics:*
Length of presentation:*
Requested Date:
Requested Time:  
Alternate Date:
Alternate Time:  
Type of Audience:
Projected number of Attendees:
Location of Presentation:
Address: *
City: *
Zip Code *
Directions to Location:
Brochure and Equipment needs: only 500 characters allowed
Security Code *
 

Please type the Security Code exactly as it appears in the image above. The code is CaSe SeNsItIvE. This helps prevent automated submissions.

 

Brevard County Emergency Management Office

1746 Cedar Street
Rockledge, Florida 32955
Tel: (321) 637-6670
Fax: (321) 633-1738

Director
Kimberly Prosser

 
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Board of County Commissioners
2725 Judge Fran Jamieson Way  Viera, FL 32940
Tel: (321) 633-2000 or Florida Relay 1-800-955-8771
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Under Florida law, e-mail addresses are public records. If you do not want your e-mail address released in response to a public-records request, do not send electronic mail to this entity. Instead, contact this office by phone or in writing.