March 3, 2020 AWR-347 Climate Adaption Planning for Emergency Managers-Warren County

Registration

Question Title

* 1. Complete Name and Address:

First Name: *

Last Name: *

Work Address: *

Work Address 2:

City/Town: *

State: *

ZIP: *

Agency *

Email Address: *

Phone Number: *

Question Title

* 2. Please Provide Your FEMA SID Number. You will need to create a FEMA SID Number to be enrolled in to the course if you do not have one. (If you do not have a FEMA SID Number please visit FEMA's website at https://cdp.dhs.gov/femasid)

Question Title

* 3. Rank/Position/Title

Question Title

* 4. How many years have you been at your current position?

Question Title

* 5. Please provide your supervisors name

Question Title

* 6. Please provide your supervisors phone number

Question Title

* 7. What is your level of government?

Local

State

Federal (DHS)

Federal (Non-DHS)

Tribal

Not Applicable

Question Title

* 8. What is your discipline?

Agricultural Safety (Pre and Post Harvest) (AGS)

Animal Emergency Services (AES)

Citizen/Community Volunteer

Emergency Management

Emergency Medical Services

Fire Service

Governmental Administrative

Hazardous Materials

Healthcare

Information Technology

Law Enforcement

Private Sector/Corporate Security and Safety Professionals

Public Health

Public Safety Communications

Public Works

Search and Rescue

Transportation Security (Air, Water, Ground, Port)

Other (please specify)

Question Title

* 9. Are you a US Citizen? (If No, Please E-mail OEM.Training@dhses.ny.gov for further instruction)

Yes