To be sent to the ERCC (Mon-Fri 9-17h) / Email:
Tel: +32-2-29-21112

Please provide the information requested in the areas marked in blue.

For more information on the service and a printable/editable version of this form, please refer to http://emergency.copernicus.eu.

Activation details
Activating institution
National Focal Point EC Services EEAS
Organisation Name:
Contact Person:
Phone: / (Office) / Mobile:
E-mail: / Fax:
Date: / // (dd/mm/yyyy)
Activated on behalf of
(if applicable)
Activation details
Region/district, country:
Brief description of the activation:
(event type, affected population, etc.)
Intended use of the maps to be produced:
Product Details
Map types
Please select the product type and provide a brief description/name (e.g. Earthquake hazard analysis for Teheran; Flood risk analysis for population and assets in Senegal; Evacuation plan for Haiti; etc.)
Type / Short description/name
Reference map
Pre-disaster situation map
Post-disaster situation map
Detailed description
Please provide in the following text field more details on the product(s) you need., e.g. a list of maps you require (map name, size, scale), spatial and thematic detail you need, coordinate system, etc.
Risk information
Please select the information you need and possibly provide further details.
Hazard:
Exposure: population
Exposure: assets
Risk:
Consequences (e.g. delineation of the event impact area and damage grading):
Other, please specify:
Topographic features
Please select the information you need.
Hydrology (rivers, lakes, reservoirs and open water, etc.)
Toponyms and administrative boundaries
Physiography (cliffs, contours and spot heights, etc.)
Land cover (cropland, grassland, forest, natural vegetation, bare soil, wetlands, etc.)
Settlements, both formal (urban, suburban, rural, etc.) and informal (slums, IDP camps, etc.)
Transport (all transport networks and related infrastructure, e.g. roads, tracks, trails, railways, bridges, harbours, airfields)
Industry and Utilities (industrial facilities and power stations)
Assets (settlements, transport networks, , industry and utilities) will be characterized, with the following detail:
–  For scales 1:1,000 – 1:10,000: asset (e.g. building) footprints
–  For scales 1:10,001 – 1:50,000: building blocks
–  For scales 1:50,001 – 1:500,000: built-up areas
Area Of Interest (AOI, geographical location)
Please provide the AOI either as file together with this form (see a) or as coordinates (see b). You can use the Map Coverage Planner to generate the KML: http://emergency.copernicus.eu/mapping/tools-mapcoverageplanner
a)  Shapefile/KML
(WGS84 Geographic only) / Filename:
b)  Coordinates
/ Rectangular AOI / AOI around centre point
Lat:
Long:
Buffer radius around point
km
Lat / Long
Upper left:
Low right:
Delivery Details
All map(s) will be available on the FTP site (and shortly after on the EMS portal) in the following formats: printable map (geospatial PDF), georeferenced map (JPEG & GeoTIFF), vector files (Shp & KML/KMZ)
The size for printing digital map sheets is ISO A1 (841 mm x 594 mm). Please note that Map size and Map scale are linked (refer to the Manual of Procedures for more information and examples).
The default language for all products is English.
Data the user could share
Please mention local data you could share and which may help the map preparation or validation
Data / Content/Format/scale-detail/date / Share with the SP (map preparation) / Share with the ERCC
(for map validation)
Aerial imagery
Topographic data
Ground control points
Model output
Other:
Comments / Further specifications / Instructions / Other information
Any additional comment/request you may need to submit (e.g. on additional formats, special requirements (dissemination restrictions, other map size, etc.).