NC Disaster Response Network Training Registration

Please enter your information below to register for the NC Disaster Response Network Training. All fields are required.

You will be given a user name and password to access the online training which will be sent to the email address you provide. Allow 3 business days for receipt. Your information (questions 1-6 below) will be shared with the North Carolina Disaster Response Network and its participating organizations. For questions contact the North Carolina Center for Public Health Preparedness at 919-843-5561.

Complete the contact information below for your workplace (preferred) or your home Address:
Address 2:
City/Town:
State/Province:
ZIP/Postal Code:

Training Registration Form

1. Your first name

2. Your last name

3. Your email address

4. Complete the contact information below for your workplace (preferred) or your home

5. Your professional mental health licensure/certification

6. You are interested in receiving professional continuing education credits for your participation in this training.

7. Your requested password (must be at least 8 characters with no spaces)