Form Center

Standby Request Form

2. Standby Request Form
   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.
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