Standby Request Form

2. Standby Request Form
   Thank you for your interest in securing Schertz EMS for your event! <br> <br> Please fill out the information below and we will be in contact with you shortly.

   Thank you for your interest in securing Schertz EMS for your event!
   
   Please fill out the information below and we will be in contact with you shortly.

4. Organization Name

5. Organization POC

7. Organization Address

9. City

10. State

11. Zip Code

13. Email Address

14. Phone Number

16. Organization W-9

    Please upload the organization's W-9 to ensure we have correct billing information.

18. Event Name

19. Event Date

21. Event Address

23. City

24. State

25. Zip Code

27. Event Start Time

28. Event End Time

30. Unit Selection

    1. Ambulance ($125.00/hour)
    2. Gator ($95.00/hour)
    3. Unsure

32. If you have any questions or concerns, please contact Schertz EMS at 210-619-1400.

    If you have any questions or concerns, please contact Schertz EMS at 210-619-1400.

Leave This Blank:


34. 1. Receive an email copy of this form.
35. Email address

    This field is not part of the form submission.

36. Submit

* indicates a required field