Submit:Create Account
Contact Information

This information is required.
First Name *
Last Name *
Street *
State *
City *
Zip *

Please provide at least one phone number with area code.
Home Phone
Work Phone
Cell Phone
Email *
Confirm Email *
Counties
Residence County
Where you live *
Training County
Where you trained *
Reporting County
Where you report hours *
Username & Password
Username
You can use your email address or any combination of characters *
Password
Click Help for minimum pswd requirements. *
Help

Passwords have minimum requirements of:

  • 8 characters,
  • 1 upper case letter,
  • 1 lower case letter,
  • one number
  • and 1 symbol.

Please enter a password that fits all of these criteria.
Confirm Password
Should be hard for others to figure out *
Other Information
What year did you start EMG Training?
(YYYY format) *
Photo
You may upload a photo if you like
 
Select File...

Drag a file and drop it here
Do you wish to receive email from the program? *
Do you choose to hide your contact info from other EMGs in your group? *
Submit:Create Account