Registration

(This is a FREE event)

Thank you for your interest in the upcoming "Partnerships in Emergency Preparedness: Center for Faith-Based and Community Initiatives" (CFBCI). Please take a minute to complete this form and mail to the address shown below.

Mail: DHS Emergency Preparedness Workshop
P.O. Box 310656
Miami, FL 33231-0656

Name:
Title:
Organization:
Address:
Apt/Unit:
City:
State:
 Zip:
Phone: (Area code first)
no spaces or special characters please
E-Mail:
Fax: (Area code first)
no spaces or special characters please
Please choose the location for the workshop you would like to attend
Please check all that apply to your organization role:
Community Organization Emergency Manager
Private Sector Non-Profit Organization
Federal Government Speaker/Presenter
Local & State Government Other
Faith-Based Organization
So that we may assist you better, please check special accommodations you may need:
Wheelchair accessibility Sign language interpreter
Accommodation for service animal Other
No accommodations needed  
Please click once