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City of Salina

support@salina.org

300 W Ash, Salina, KS, 67401, US

Special Needs Alerts and Identification Location Alert Update Form

If you are a parent, guardian, caregiver or individual who has an established S.A.Id. Alert in the Salina Police Department's database, please complete the following form to update your location alert. Remember, this form must be submitted annually for the alert to remain active in the database. If you have a question regarding any portion of the form or the status of your alert, please send an email to wayne.pruitt@salina.org and Amber Pfeifer at amber.pfeifer@salina.org.

Full Name

Date of Birth

Address

Descriptive Information

Photo

Please upload a recent photo of the individual that includes only their head and shoulders. If possible, also send a digital version of the photo (png or jpeg format) to wayne.pruitt@salina.org and  amber.pfeifer@salina.org. Make sure to include the individual's name and date of birth in the email.

Upload Photo

School or Daycare Information (if applicable)

Address of School or Daycare

S.A.Id. Location Form completed by:

By submitting this form, I certify that the information provided is true and accurate to the best of my knowledge. I understand that I voluntarily provided the information within this form and that it will not result in any type of preferential treatment from first responders. I hereby grant the Salina Police Department to create an alert utilizing the above information and consent to that information being shared with the Salina Fire Department and the paramedics and ambulance service.

Authorization for Alert