Mississippi Department of Education
Emergency Evacuation Information Form
School District:
Date:
Primary Contact
Name
Title
Work Phone Number
Cell Phone Number
E-mail Address
Physical Address
City, State, Zip
Secondary Contact
Name
Title
Work Phone Number
Cell Phone Number
E-mail Address
Physical Address
City, State, Zip
Chief Security
Administrator/Officer
Name
School
Work Phone Number
Cell Phone Number
E-mail Address
Physical Address
City, State, Zip
In the event of an emergency, if tasked by the State Superintendent, how many regular route
buses, along with drivers* and school safety or school resource officers, from your district can be
utilized without interfering with normal school operations? How many regular route buses with
powerlifts from your district can be utilized?
Buses
Buses with Powerlifts
Drivers
Safety Officers
*School districts will provide trained school bus drivers with proper credentials when available and, if not available, provide bus
operators without a commercial driver’s license as permitted in Section 31-41-27 of MS Code of 1972, Annotated.
Information for use by Mississippi Department of Education in case of emergency only.