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4. Check one of the following drills:*

   1. FIRE
   2. LOCKDOWN
   3. TORNADO
   4. SAFETY EVACUATION
6. Date*
   Date
7. Time*
   Time
9. Weather Conditions:
   -- Select One --CLEAROVERCASTWINDYRAINSNOW
10. Temperature:
14. Name of School:*
16. Number of Classrooms:*
18. Number of Students:*
20. Number of Teachers:*
24. Time Required to Evacuate or Lockdown the Building:*

    Example: 2 mins 30 secs

25. Time Required to Verify Evacuation or Lockdown:*

    Example: 2 mins 30 secs

27. Was a Member of the Police or Fire Department Present?

    List of Names

29. Is the Fire Alarm in Good Working Order:*

    1. YES
    2. NO
31. Comments:
35. Fire Department Issued Security Code:*
37. Representative Filling Out this Form:*
39. Email:*
41. Location:*

    1. Vandalia
    2. Butler Township - Smith Middle School
Leave This Blank:


43. 1. Receive an email copy of this form.
44. Email address

    This field is not part of the form submission.

45. Submit

* indicates a required field