I.

FAMILY INFORMATION

A. Name of Family

TABILIN FAMILY

B. Address

124, ZONE 3 BGRY. PANTAL MANAOAG PANGASINAN

C. Contact Information of family members

Name Family Cellphone Email address Facebook

position number name
CELSO R. FATHER
TABILIN
CASELYN T. SISTER
PURAZO
CHRISTIAN BROTHER
V. TABILIN
CELINA V. YOUNGEST
TABILIN SIBLING

D. Pet Information

Name Type Color

II. HAZARD IDENTIFICATION
What hazards in our area are most likely to affect our family?

Type of Hazard Yes No

Earthquake
Flooding
Typhoon
Rain or Earthquake Induced Landslide
Tsunami/Storm Surge

III. SCENARIO PLANNING

A. In the event of a disaster and you are WITH YOUR FAMILY, what do we
do?

STEPS DESCRIPTION
1

B. In the event of a disaster and you are NOT WITH YOUR FAMILY, what do
we do?

STEPS DESCRIPTION
1

C. 3 Family meeting places if separated during a disaster (By priority)

 1
2
3

D. Emergency contact person(s) outside family

Name Cellphone Email Facebook Name

Number

E. If children/siblings are at School/ Work, what do we do? What are the

contact information of their schools and work places?

STEPS DESCRIPTION
1

Name of School/Work Contact Email Address

Information

F. What do we do with our family members who are PWDs and Elderly?

STEPS DESCRIPTION
1

2
 3

IV. ROLES AND RESPONSIBILITIES

Family Member
Task Description
Responsible

V. EVACUATION MAP

Home

Family
meeting
place

Sample map only

VI. EMERGENCY GO-BAG

We do not
EMERGENCY GO-BAG INCLUDES; We have
have
Drinking water in sealed containers enough
for 3 days
Spare cash including coins
 Flashlight
Whistle
Candles & matches
Easy to serve, ready-to-eat food enough for 3
days
clothing
Rain coats
boots
Sanitary supplies
radio
Fresh batteries
Mobile phones
Power banks
Cellphone chargers
Sleeping bags
Matts
Blankets
Ropes
Old newspaper
Eco bags made from strong materials
Items for special needs of younger and older
members of the family including PWDs
Items and kit with remedies for fever, LBM,
minor wounds, pain, and maintenance
medicines
Important documents in waterproof
containers

(Please include pictures)

VII. EMERGENCY HOTLINE NUMBERS

Brgy. Captain
Brgy. Health Worker/Kagawad
City/Municipality DRRM Office
City/Municipality Bureau of Fire
City/Municipality Philippine National
Police
Others