Litchfield County Regional First Responder Registration Form
Click
Here
for a quick video on how to obtain your Active911 Registration Code
Username (first initial, last name)
*
Password
*
Retype Password
*
Full name
*
Email
*
Cell Phone Number
*
Cell Phone type
*
Select your phone type
Android
iPhone
Windows
BlackBerry
Other
Portable Radio Call Sign
Active911 Registration Code
Member of
*
Select your Service
Harwinton EMS
New Hartford EMS
Norfolk EMS
Norfolk FD
Winsted EMS
CPR Expiration Date
*
EMR Cert Expiration Date
EMT Cert Expiration Date
Advanced EMT/Medic Expiration Date
I have read and understood the RFR policy and procedures. I understand strict adherence is required!
*
I have been issued proper FR equipment including, but not limited to a vest and picture ID as well as a portable radio.
*
Captcha
*
There is no need to fill in this field
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