To register for MAP Client Services, please enter your information and click the Submit button. You will be notified via email when your registration is processed.
Account Name:
First Name:
Last Name:
Title:
E-Mail:
Address:
City:
State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Zipcode:
Phone Number:
Briefly describe the safety and risk management issue you would like to address:
If you are registering for S:ERVE, please complete this section:
Minimum Passing Score:
Min Passing Score 100% 95% 90% 80% 85% 80% 75% 70% 65% 60% 55% 50% 45% 40% 35% 30% 25% 20% 15% 10% 5% 0%
Notify Instructor: Select this box to automatically receive notification when a student completes a course.
Indicate the number of employees you plan to train within your organization for each of the following*:
Ambulance Police Fire
*Training is not guaranteed for all employees.
