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Deaf and Hard of Hearing Registration

  1. Use this form to register as a deaf or hard of hearing individual in Amherst. Information from this form will be used by public safety officials for notifications in the event of an emergency.

  2. In non-emergency events what is your preferred method of communications with the Town of Amherst?

  3. Is it OK to contact you to verify the information you have submitted?*
  4. Leave This Blank:

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