Fire & Police Advocates

Information Update Form

 

If you have been appointed as the fire or police advocate for your department and your up to date information has not been submitted to the Citizens Commission for the Safety and Care of the Elderly,

please download this form, print/mail or email it to:

Chief Richard Susi, Ret.

at rifirechiefs@gmail.com or

PO Box 6041
Providence, RI, 02940

 

 

Department or District Name: __________________________________________

 

Advocate Name: _____________________________________________________

 

Advocate Contact information:

 

Email address: __________________________________

 

Business phone: _________________________________

 

Cell phone: _____________________________________

 

Other phone: ____________________________________

 

 

For verification purposes, please provide the name and contact information of the chief, supervisor or person responsible for appointing you an elderly advocate:

 

Name________________________________________Phone___________