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					Basic Information:
School District:
Person Completing Form:
Phone Number:

District-Level Information:
Job Title:                                       Name:   Official Title: Mailing Address:   Daytime Phone: Alternative Phone: Fax Number:
Director of Schools:
Director of Schools Designee:
SAVE Act/District Safety Planning Coordinator:
Crisis Intervention/Postvention Coordinator:
Public Information Officer:
Transportation Supervisor:

School Safety Planning Coordinator(s):
School Name:                                     Name:   Official Title: Mailing Address:   Daytime Phone: Alternative Phone: Fax Number:
Email Address:

Email Address:
Instructions for Completing the Excel Spread Sheet:
Please provide information on your district and school emergency coordinators. This includes
identifying and providing contact information for the following individuals: the Director of
Schools, Director of Schools Designee, SAVE Act/District-Level Emergency Coordinator, Crisis
Intervention/Postvention Coordinator, Public Information Officer (PIO), and Transportation
Supervisor. In addition, please designate a School-Level Emergency Coordinator for every
school in your district. Below, you will find a job description for each of the individuals listed
above. After completing the Excel template, print a copy of the document and include it with
the materials you mail to the department. Also, email an electronic copy of the spreadsheet to: When saving the document, use your district’s name as the file

For all the individuals listed above, be sure to include all of the following information: school
name (if applicable), name, office title, mailing address, daytime phone, alternative phone, fax

Job Titles Descriptions:
Director of Schools Designee
The Director of Schools Designee is the individual that assumes responsibility for decisions in
the Director’s absence (in the event of an emergency and/or crisis event).
SAVE Act/District Safety Planning Coordinator
The SAVE Act/ District Safety Planning Coordinator is responsible for organizing the district’s
school safety programs and insuring the district’s compliance with the SAVE Act and other
safety-related legislative or policy requirements.
Crisis Intervention/Postvention Coordinator
The Crisis Intervention/Postvention Coordinator is responsible for organizing the school
district’s crisis intervention strategy (counseling, staff/family support services) including
establishing linkages with local mental health agencies. This individual coordinates the mobile
crisis /postvention team that is available to support schools during the recovery phase of a
Public Information Officer
The Public Information Officer (PIO) is the communications spokesperson responsible for
providing timely, accurate information to the public during a crisis and/or an emergency
Transportation Supervisor
The Transportation Supervisor is responsible for the district’s pupil transportation services.
School Safety Planning Coordinator (one per school/building)
The School Safety Planning Coordinator is responsible for organizing the safety plans and
programs of a specific school including SAVE Act compliance issues such as the maintenance
of a school safety team and the sharing of building-level plans with first responders.

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