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form-oa-mutual-aid-request.html
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form-oa-mutual-aid-request.html
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<!DOCTYPE html>
<html>
<head>
<meta http-equiv="Content-type" content="text/html;charset=UTF-8">
<link rel="stylesheet" type="text/css" href="resources/css/loading.css"/>
<link rel="stylesheet" type="text/css" href="resources/css/pack-it-forms.css"/>
<link rel="stylesheet" type="text/css" href="resources/css/ics-header.css"/>
<link rel="stylesheet" type="text/css" href="resources/css/ics-footer.css"/>
<style>
td {
white-space: nowrap;
}
</style>
<script type="text/javascript" src="resources/js/pack-it-forms.js"></script>
<script type="text/javascript" src="resources/integration/integration.js"></script>
<script type="text/javascript">
var standardStartup = integration.late_startup;
integration.late_startup = function(next) {
standardStartup(function() {
document.getElementById("scco-banner").style.backgroundColor = "#e3efd9";
next();
});
};
</script>
<meta name="pack-it-forms-pdf-URL" content="pdf/SCCo_RACES_MA_Req_v190531_Fillable.pdf">
<meta name="pack-it-forms-subject-suffix" content="_RACES-MAR_{{field:15.agency}}">
<title>RACES Mutual Aid Request</title>
</head>
<body>
<div class="version">1.6</div>
<%#include%>resources/html/loading.html<%/include%>
<form id="the-form" name="the-form">
<%#run%>include("resources/html/scco-header.html", {
"title": "Santa Clara County RACES -- Mutual Aid Request",
"version": "Version: 190419<br/>PIF: {{version}}"
})
<%/run%>
<table class="fullsize-textfields">
<tr>
<td>
<label>Agency</label>
</td><td colspan="4">
<table class="same-line-label-layout">
<tr>
<td style="width:1px;">Name:</td>
<td><input type="text" name="15.agency" tabindex="20" required/></td>
</tr>
</table>
</td>
</tr><tr>
<td style="white-space:normal;">
<label>Event / Incident</label>
</td><td colspan="4">
<table class="same-line-label-layout">
<tr>
<td style="width:1px;">Name:</td>
<td><input type="text" name="16a.event-name" tabindex="21" required/></td>
<td style="width:1px;">Number:</td>
<td style="width:10em;">
<input type="text" name="16b.event-number" tabindex="22"/>
</td>
</tr>
</table>
</td>
</tr><tr>
<td style="width:1px;">
<label>Assignment</label>
</td><td colspan="4" style="padding-right:1em;">
<textarea name="17.assignment" rows="4" tabindex="23" required
placeholder="Duties, conditions, equipment, shift times"></textarea>
</td>
</tr><tr>
<td style="white-space:normal;">
<label>Amateur Radio Resources Requested</label>
</td><td style="width:3em;text-align:right;">
<label style="font-weight:normal;">Qty:
<textarea name="18a.resources-qty" tabindex="24" required
rows="3" style="text-align:right;"></textarea>
</label>
</td><td>
<label style="font-weight:normal;">Role/Position:
<textarea name="18b.resources-role" rows="3" tabindex="25" required></textarea>
</label>
</td><td style="padding-right:1em;">
<label style="font-weight:normal;">Preferred Type:
<textarea name="18c.preferred-type" rows="3" tabindex="26" required></textarea>
</label>
</td><td style="padding-right:1em;">
<label style="font-weight:normal;">Minimum Type:
<textarea name="18d.minimum-type" rows="3" tabindex="27" required></textarea>
</label>
</td>
</tr><tr>
<td style="width:1px;">
<label>Requested Arrival</label>
</td><td colspan="2">
<table class="same-line-label-layout">
<tr>
<td style="width:1px;">Date(s):</td>
<td><input type="text" name="19a.arrival-dates" tabindex="28" required/></td>
</tr>
</table>
</td><td colspan="2">
<table class="same-line-label-layout">
<tr>
<td style="width:1px;">Time(s):</td>
<td><input type="text" name="19b.arrival-times" tabindex="29" required/></td>
</tr>
</table>
</td>
</tr><tr>
<td style="white-space:normal;">
<label>Needed Until</label>
</td><td colspan="2">
<table class="same-line-label-layout">
<tr>
<td style="width:1px;">Date(s):</td>
<td><input type="text" name="20a.needed-dates" tabindex="30" required/></td>
</tr>
</table>
</td><td colspan="2">
<table class="same-line-label-layout">
<tr>
<td style="width:1px;">Time(s):</td>
<td><input type="text" name="20b.needed-times" tabindex="31" required/></td>
</tr>
</table>
</td>
</tr><tr>
<td style="width:1px;">
<label>Reporting Location</label>
</td><td colspan="4" style="padding-right:1em;">
<textarea name="21.reporting-location" tabindex="32" required
rows="3" placeholder="Street Address, Parking, Entry Instructions"></textarea>
</td>
</tr><tr>
<td style="width:1px;">
<label>Contact on Arrival</label>
</td><td colspan="4" style="padding-right:1em;">
<textarea name="22.contact-on-arrival" tabindex="33" required
rows="2" placeholder="Name/Position and contact info"></textarea>
</td>
</tr><tr>
<td style="white-space:normal;">
<label>Travel Info</label>
</td><td colspan="4" style="padding-right:1em;">
<textarea name="23.travel-info" required tabindex="34"
rows="2" placeholder="Routes, Hazards, Lodging"></textarea>
</td>
</tr><tr>
<td style="white-space:normal;" rowspan="2">
<label>Requested By</label>
</td><td colspan="2">
<table class="same-line-label-layout">
<tr>
<td style="width:1px;">Name:</td>
<td><input type="text" name="24a.requester-name" tabindex="35" required/></td>
</tr>
</table>
</td><td colspan="2">
<table class="same-line-label-layout">
<tr>
<td style="width:1px;">Title:</td>
<td><input type="text" name="24b.requester-title" tabindex="36" required/></td>
</tr>
</table>
</td>
</tr><tr>
<td colspan="4">
<table class="same-line-label-layout">
<tr>
<td style="width:1px;">Contact:</td>
<td>
<input type="text" name="24c.requester-contact" tabindex="37" required
placeholder="E-mail, phone, frequency"/>
</td>
</tr>
</table>
</td>
</tr><tr>
<td style="white-space:normal;" rowspan="3">
<label>Approved By</label><br/>
(Authorized agency official)
</td>
<td colspan="2">
<table class="same-line-label-layout">
<tr>
<td style="width:1px;">Name:</td>
<td><input type="text" name="25a.agency-approver-name" tabindex="40" required/></td>
</tr>
</table>
</td><td colspan="2">
<table class="same-line-label-layout">
<tr>
<td style="width:1px;">Title:</td>
<td><input type="text" name="25b.agency-approver-title" tabindex="41" required/></td>
</tr>
</table>
</td>
</tr><tr>
<td colspan="4">
<table class="same-line-label-layout">
<tr>
<td style="width:1px;">Contact:</td>
<td>
<input type="text" name="25c.agency-approver-contact" tabindex="42" required
placeholder="E-mail, phone, frequency"/>
</td>
</tr>
</table>
</td>
</tr><tr>
<td colspan="2" style="height:3em;padding-left:1em;">Signature:
</td><td style="width:11em;">
<table class="same-line-label-layout">
<tr>
<td style="width:1px;">Date:</td>
<td><input type="text" name="26a.agency-approved-date" tabindex="43" required
class="date" value="{{date}}"/></td>
</tr>
</table>
</td><td style="width:10em;">
<table class="same-line-label-layout">
<tr>
<td style="width:1px;">Time:</td>
<td><input type="text" name="26b.agency-approved-time" tabindex="44" required
class="time"/></td>
</tr>
</table>
</td>
</tr>
</table>
<%#include%>resources/html/scco-footer.html<%/include%>
</form>
<div class="print-only" style="page-break-inside:avoid;">
<table>
<tr>
<td class="block-caption" colspan="5">
This Section to be completed by Santa Clara County Op Area:
</td>
</tr><tr>
<td style="width:1px;"><b>Reviewed By</b> (CRO)</td>
<td colspan="2" style="height:0.25in;">Name:</td>
<td style="width:1.35in;">Date:</td>
<td style="width:1.35in;">Time (24hr):</td>
</tr><tr>
<td style="white-space:normal;"><b>Reauthorization of Request</b></td>
<td style="height:0.25in;width:2.5in;">Orig Req Msg Nbr:</td>
<td colspan="3">Req Agency:</td>
</tr><tr>
<td rowspan="2"><b>Approved By</b><br/>(SCCo OES official)</td>
<td colspan="2" style="height:0.25in;">Name:</td>
<td colspan="2">Title:</td>
</tr><tr>
<td colspan="2" style="height:0.25in;">Signature:</td>
<td>Date:</td>
<td>Time (24hr):</td>
</tr><tr>
<td><b>Completed</b></td>
<td colspan="2" style="height:0.25in;">Name:</td>
<td>Date:</td>
<td>Time (24hr):</td>
</tr>
</table>
<br/>
<table>
<tr style="background-color:#E2F0D9;">
<td colspan="5" style="border-top:1px solid #aaaaaa;">
<b>Assignments </b>(attach additional sheets if needed)
</td>
</tr><tr style="background-color:#E2F0D9;">
<td style="width:0.6in;"><b>Date</b></td>
<td style="width:0.6in;"><b>Time</b></td>
<td><b>Name</b></td>
<td style="width:0.8in"><b>Call Sign</b></td>
<td><b>Notes</b></td>
</tr><tr>
<td style="height:0.2in;"></td><td></td><td></td><td></td><td></td>
</tr><tr>
<td style="height:0.2in;"></td><td></td><td></td><td></td><td></td>
</tr><tr>
<td style="height:0.2in;"></td><td></td><td></td><td></td><td></td>
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</tr><tr>
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</tr>
</table>
</div>
<%#include%>resources/html/submit-buttons.html<%/include%>
</body>
</html>