Training Request

Before completing your training request, please take a moment to read the T&E Training Policy & Guidance.

Agency/Organization's Name:*
Agency/Organization's Address:*
Street Address Address Line 2 City State ZIP Code
Agency/Organization's Phone:*
Primary Contact's Name:*
First Last Title
Primary Contact's Phone*
Primary Contact's Email*
Enter Email Confirm Email
Alternate Contact's Name*
First Last Title
Alternate Contact's Phone*
Alternate Contact's Email*
Please describe the type of training you are requesting.*
When and where would you like to hold this training?*
Are you willing to open this training to the region, or is this intended for your agency/municipality alone?*
We strive to meet all of our stakeholders' needs. Priority will be given to regionalized training requests in order to build a more interoperable and resilient state.
- Open to the region.
- My agency/municipality only.
How many students are you looking to put through this course?*
Please enter a number from 0 to 500.
Have you previously conducted a similar training with or without HSEM?*
- Yes
- No
Please explain why this training is being requested.*
Does this training fulfill any requirements for you agency in reference to federal funding ie: EMPG?*
- Yes
- No
If so, please describe what requirement and what funding source.
Will this training fulfill any accreditation requirement?*
- Yes
- No
If so, which one?*
Your Course Request Form is complete.
By clicking Submit your form will be submitted to the Training & Exercise staff.

Your Course Request Form is complete.