This form is intended to be used by first responders who rely upon Pike County 911’s radio system as their primary form of communication. This is form is NOT for weather radio’s or for the general public. Thank you for your understanding.

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Name *

First

Last

Your Department *

Unit/Truck Number *

Email (optional)

Phone Number *

Type of Request *

• New Radio
• Install (in truck/ATV)
• Repair
• Lost/Destroyed
• Replacement

Type of Radio *

• Handheld
• Mobile

of Additional Phone

Additional Information

Include any relevant details, but keep it brief.

Submit