Public Safety PersonnelWho should register? Government employees working in Fire, EMS, OES, Public Health and any Government Agency that performs a Homeland Security function based on a "right" and "need-to-know". Notification e-mail address must be agency affiliated. Complete all required information and refrain from using abbreviations and typing in all CAPS.(No personal e-mail addresses will be accepted.)CONTACT INFORMATION(for registration purposes only)First Name *Last Name *Position/Title/Rank: *Phone Work: *Mobile Phone: Email Address: *(Use agency/organization email address)Retype your e-mail address: *
AGENCY / ORGANIZATIONAgency/Organization Name: *If your agency/organization name does not appear on the above list, enter your Agency/Organization Name below.(no abbreviations)Other Agency/Organization Name:Current Assignment/Division/Station: *(Spell out - No acronyms)Describe Your Current Duties, Role and Responsibilities * Address: *Address 2:City: *County: * - Select County -Los AngelesOrangeRiversideSan BernardinoSanta BarbaraSan Luis ObispoVenturaOtherState:*Zip code:*
SUPERVISOR INFORMATIONSupervisor Full Name: *Supervisor Phone: *Supervisor Email Address: *PROFILE ACCESS
Password: *(Create a password to access profile / must be 8 characters minimum 1 numeric and 1 special)
All registration information is considered strictly confidential.