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2. What is a Functional Need?
   
   The Silver Spring Township Special Needs Registry is a voluntary, community outreach service to assist elected officials and emergency responders in obtaining important information on special needs residents living in the township.
   
   The Registry assists residents by ensuring that emergency response units (fire, police, EMA) have access to the information during an emergency situation.
   
   Providing information to the Special Needs Registry is completely voluntary. Under state law, municipalities are required to keep information on special needs persons, and this Registry provides a methodology to do so. Also, state law requires group living arrangements to provide their own emergency plan.
   
   The Silver Spring Township Special Needs Registry is a resource for residents with special needs who do not have a reliable source of assistance in the event of an emergency.
4. Today's Date*
   Today's Date

   Today's Date
6. First Name
7. Last Name
8. Spouse
10. Address1
12. Address2
14. City
15. State
16. Zip
18. Phone Number
19. Cell Phone
21. Describe your Functional Need
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23. 1. Receive an email copy of this form.
24. Email address

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25. Submit

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