Association of Louisiana Electric Cooperatives Emergency Assistance Emergency Assistance Request Form Font Size: Share Share on FacebookShare on X (Twitter)Share on PinterestShare on LinkedinShare on Email Feedback Print
Emergency Assistance Request Form Emergency Assistance Request Form "*" indicates required fields Cooperative Requiring Assistance*Primary Contact's Name* First Last Primary Contact's Phone Number*Primary Contact's Email* Secondary Contact Name(s) and Phone NumbersWhen entering multiple secondary contacts, please use the following format: Name (123)456-7890; Name (123)456-7890. Nature of Disaster*Estimate Number of Members Affected*Estimate of Line Damage and Percentage of Miles*Weather and Road Conditions*Where and to Whom Should Crews Report?*Please include the location, name, and phone number using the following format: Location, Name (123)456-789.Estimation of Length of Time Outside Crews Are Needed*System Voltages*Requests for TrucksType of Truck and Quantity RequestedPlease use the following format: Truck Type (Quantity); Truck Type (Quantity); etc.NotesRequests for Equipment and ToolsType of Equipment/Tool and Quantity RequestedPlease use the following format: Tool/Equipment (Quantity); Tool/Equipment (Quantity); etc.NotesRequests for PersonnelPersonnel Classification and Quantity RequestedPlease use the following format: Personnel Classification (Quantity); Personnel Classification (Quantity); etc.NotesRequests for MaterialsMaterials and Quantity RequestedPlease use the following format: Material (Quantity); Material (Quantity); etc.Notes
