2015 Emergency Management Certification and Training Academy

Registration Form

The 2015 Emergency Management Certification and Training (EMC&T) Academy will be held in downtown Albany. The Tier 1 Training for County Chief Executives will be August 17th and the Tier 2 for County Emergency Managers will be from August 17-August 20th. There will be an evening networking reception following the Tier 1 portion of the program on August 17th.

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* 1. Please provide your name and contact information:

Name

Title

Agency

Email Address

Phone Number

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* 2. Affiliation:

State Agency or Presenter

County

If County, please specify:

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* 3. Please select who you will be representing:

Tier 1: County Chief Executive (i.e. County Executive, Chairman of the Board, etc.)

Tier 2: County Emergency Management

State Agency

Presenter

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* 4. At the conclusion of the training on August 17th, DHSES will be hosting a networking reception. All are welcome to attend. For planning purposes, please RSVP below if you will be attending the networking reception.

Yes, I am able to attend the networking reception

No, I am unable to attend the networking reception

2015 Emergency Management Certification and Training Academy

Registration Form

Question Title

* 1. Please provide your name and contact information:

Question Title

* 2. Affiliation:

Question Title

* 3. Please select who you will be representing:

Question Title

* 4. At the conclusion of the training on August 17th, DHSES will be hosting a networking reception. All are welcome to attend. For planning purposes, please RSVP below if you will be attending the networking reception.

Question Title

* 5. Do you have an special dietary needs or need for other special accommodations?

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* 6. Do you have any additional comments or questions?