Department Information Update

Name of Department*
Type of Department
- Career
- Call
- Volunteer
- Combination
Career: A department comprised of solely full-time members
Call: A department comprised of solely on-call or part-time members
Volunteer: A department comprised of solely volunteer members that receive no compensation
Combination: A department comprised of both full-time, part-time, on-call and/or volunteer members
Department Representative Name*
First Last
Department Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Department Phone #*
Department Email*
Department Website
This field is hidden when viewing the form
Please upload the most current roster of ACTIVE members that you have on the department. This can be a word document, PDF file, XLS or CSV file. This list MUST contain member first name, last name, date of birth, address, phone number, and member status.
Max. file size: 256 MB.
For member status, please use the following:

FT - Full-time/Career
PT - Part-time/Per diem
V - Volunteer
C - Call
E - EMS only
A - Administrative only