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Username and Password
Username: *
Email: *
Password: *
Confirm Password: *
Contact Information
First Name: *
Middle Initial:  
Last Name: *
Work address: *
Work address 2:  
City: *
State: *
Zip Code: *
Work Phone: *
Employment Information
Job Title:  
Employer / Agency:  
Government Level: *
Student Discipline: *
Fema Training
Fema ID:  
Citizenship (If not a citizen, please select country below)
U.S. Citizen: *
Yes, I am a U.S. Citizen.  
Country: *
If not a US citizen please select your country of origin:
Confidentiality of Information

Your responses and all personal information will remain confidential. Any reporting of data will be done anonymously in an aggregated fashion, without names or identifiers.

Public Reporting Burden

Under the Paperwork Reduction Act, a person is not required to respond to a collection of information unless it dislays a currently valid OMB control number. Forms are created and instructions are provided so that they are accurate and can be easily understood while imposing the least possible burden on you to provide the requested information. The estimated average time to complete and file this application is 15 minutes per form. Send comments regarding the accuracy of the burden estimate and any suggestions for reducing this burden to Information Collections Management, DHS/FEMA, 500 C Street SW, Washington DC 20472.

OMB Control Number: 1660-NEW