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MOHSEP TRAINING

 

EMAP Accredited Program

East Baton Rouge Parish

Mayor's Office of Homeland Security & Emergency Preparedness


COURSE APPLICATION

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PRIVACY ACT STATEMENT: Solicitation of the SSN is authorized under the provisions of E.O. 9397, dated November 23, 1943. The disclosure of your SSN is voluntary and is only for record keeping purposes. The SSN is used as an identifier to match the person completing the training with the correct master record in order to better assist you in obtaining certifications of completed courses. The use of the SSN is necessary because of the large number of individuals who have identical names and birth dates and whose identities can only be distinguished by the SSN.

Fields marked with red text are required.
PERSONAL INFORMATION
First Name
Middle Initial
Last Name
Suffix (Please enter Jr., Sr., and such in Suffix instead of in the Last Name field.)
EMPLOYMENT INFORMATION
Employer
(type if not listed)
Job Title
Address
City
State
Zip/Postal Code -
Parish/County
or County:
Work Phone () -
 
FAX () -
 
E-mail
i.e. johndoe@email.com

For security purposes please type the numbers and decimals exactly how it appears in the box above.
     
East Baton Rouge
Mayor's Office of Homeland Security & Emergency Preparedness
3773 Harding Blvd.
Baton Rouge, LA 70807
(225)389-2100- Phone
(225)389-2114 - Fax


For any additional information please contact
the office at (225) 389-2100 or e-mail oeptraining@brgov.com

If you feel the information on this page is incorrect or out dated, please contact this department's content manager.

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