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Jersey City - Newark UASI

Fire Registration
By registering and becoming a partner in the Jersey City-Newark Urban Area Initiative you will be notified of upcoming trainings, events and relevant information to your discipline. If eligible, you may be asked to participate in planning and working group sessions that inform regional policy and operational concepts.

CONTACT INFORMATION
First Name:  *

Last Name: *

Position/Title/Rank:  *

Phone Number: *

Mobile Phone: 

Email Address:  *
(Agency/Organization Email Addresses Only)

Please re-type your email address: *

City: *

County: *

State:*

  


AGENCY / ORGANIZATION
Agency/Organization Name:  *


Discipline / Assignment / Role: *


SUPERVISOR INFORMATION CONTACT
Full Name: *

Supervisor's Title: *

Phone Work: * 

Supervisor's Email Address: *
(Agency/Organization Email Addresses Only)


WEBSITE ACCESS
Password: *
Create a password for site access / modify your contact information.  (min 8 characters; 1 numeric, 1 special)



All registration information is considered strictly confidential and will not be shared.

Jersey City - Newark UASI Non-Disclosure Agreement

I agree to keep “sensitive information” provided by the Jersey City - Newark UASI (NNJ UASI) confidential and protect and restrict its access based on a right and need to know.

I have read, understand, and agree to abide by the above terms.