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HEALTHCARE / PUBLIC HEALTH RegistrationWho should register?  Partners with a "right" and "need-to-know" sensitive public safety information who are currently employed in a public health role, such as infectious and communicable diseases, food and water safety, emergency medical services, hazardous material management, and government hospitals; have attended a Terrorism Liaison Officer (TLO) Basic course or (ILO Basic training course via InfraGard); and submitted a copy of their TLO/ILO certificate to JRIC for verification (via email to training@jric.org). Subscription email addresses must be agency-affiliated. No group or personal email addresses.

(for registration purposes only)
First Name  *

Last Name *

Position/Title:  *

Phone Work: *

Mobile Phone:

Email Address:  *
(Use company / organization email address)

Retype your e-mail address: *

AGENCY / ORGANIZATION
Agency/Organization Name:  * (no abbreviations)

Current Assignment: *
(Spell out - no acronyms)

Describe Your Current Duties, Role and Responsibilities *
 
Address: *

Address 2:

City: *

County: *

State:*

Zip code:*


SUPERVISOR INFORMATION
Supervisor Full Name: *

Supervisor Phone: *

Supervisor Email Address: *


PROFILE ACCESS
Password: *
(Create a password for site / must be 8 characters minimum 1 numeric and 1 special)


All registration information is considered strictly confidential.

  

I agree to the following terms and conditions:

NONDISCLOSURE TERMS & CONDITIONS AGREEMENT BETWEEN THE JOINT REGIONAL INTELLIGENCE CENTER (JRIC) AND THE APPLICANT PERTAINING TO THE PROPER HANDLING OF "FOR OFFICIAL USE ONLY" (FOUO)" INFORMATION.

1. I hereby accept the obligations contained in this Agreement in consideration of my being granted access to FOUO information. As used in this agreement, FOUO information is marked or unmarked FOUO information, including oral communication, which is FOUO information under the standards of the JRIC. I understand and accept that being granted access to FOUO information, special confidence and trust shall be placed in me by the JRIC.

2. I hereby acknowledge that I have read the attached document, titled "Safeguarding Sensitive but Unclassified Information" and a copy has been provided to me, and that I have received a security indoctrination concerning the nature and protection of FOUO information, including the procedures to be followed in ascertaining whether other persons to whom I contemplate disclosing this information have been approved for access to it, and that I understand these procedures.

3. I have been advised that the unauthorized disclosure, unauthorized retention, or negligent handling of FOUO information by me could cause damage or irreparable injury to the JRIC. I hereby agree that I will never divulge FOUO information to anyone unless: (a) I have officially verified that the recipient has been properly authorized by the JRIC to receive it; or(b)I have been given prior authorization from the agency responsible for the information that such disclosure is permitted; or (c) the recipient has the "need to know" in order to perform their official duties. I understand that if I am uncertain about the classification status or handling control authority of information received from the JRIC, I am required to confirm from an authorized JRIC official that the information is FOUO before I may disclose it, except to a person as provided in (a) or (b) above.

4. I have been advised that any breach of this Agreement may result in the termination of my affiliation with the JRIC. 5. I have read this agreement carefully and my questions, if any, have been answered.
I agree to the above terms and conditions: