Form Center

By signing in or creating an account, some fields will auto-populate with your information.

Resident Special Needs Identification Card

  1. Any and all information provided in the form is provided VOLUNTARILY! Please request a new ID card on a yearly basis if the applicants appearance and/or information has changed. This will ensure our first responders have the most up to date information.
  2. Applicants Information
  3. Month/Day/Year
  4. Ex. 981 Caldwell Ave. Union, NJ 07083
  5. full (more than one if applicable)
  6. Enclose a digital photo. (Close up Vertical Photo)
  7. Emergency Contact Information
  8. Ex. 981 Caldwell Ave. Union, NJ 07083
  9. Please add all the helpful information that will assist the first responders. Please feel free to add what your the applicant likes and dislikes, so this will help the first responders with the initial contact. **Please limit to 135 characters or less**
  10. ** Be Advised**
    All of the above information will be put into our VCAD system, which will provide our first responders with all of the vital information. Please call Officer Ribau at (908) 851-5044 for assistance or with any questions / concerns.
  11. Leave This Blank:

  12. This field is not part of the form submission.