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OPERATION PARTNERSHIP EMERGENCY NETWORK
Perimeter Access Card Application
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- Date of Application__________________________
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- Name of Applicant___________________
Position______________________________
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- Organization_______________________
Address_______________________________
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- City__________________________________
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- Number of Employees_______ Square Footage ________Total
Number of Floors _____
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- Facility Manager______________________________ Phone
Number_______________
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- Contact Numbers Work
________________________________________________
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Pager_________________________________________________
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- Cell
__________________________________________________
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- Home (Optional)
_______________________________________
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- E-mail
_______________________________________________
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- Access Cards
are the property of Operation Partnership Emergency Network
(OPEN). Open reserves the right to refuse or revoke access
cards at any time.
- DO NOT WRITE BELOW THIS LINE. FOR OFFICIAL USE ONLY.
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- Application: Approved___________ Denied_________
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- Access Card Number ____________ Date of
Issuance_____________________
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- Approved by ________________________________ Issued by
____________________
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- Mail, Fax or E-mail Application and waiver to:
- Ofc. J. Cox #3256
- Neighborhood Police Officer NPD#1
- 501 Jones St
- Ft.Worth, Tx 76102
- Cell 817-851-2520
- Office 817-392-3963
- Fax
817-392-3985
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julie.cox@fortworthgov.org
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