Please Fill Out the Registration Form Below
(* denotes required field)
 
  Organization Key  
  Challenge License Key  
  (An organization key will associate your account with your school, department or organization. If you have not been issued an organization key, leave this blank and continue with the form below. If you have an organization key, enter it here and click submit.)  
(License keys entered here will enable purchased licenses for your new Challenge System account.)
 
 
Personal Information
First Name*
     Address Line 1*  
  Last Name*
     Address Line 2  
  Email Address*     City*  
  Login Name*     State*  
  Login Password*     Zip*   (ex. 012345 or 01234-1234)
  Password Confirm*     Phone*   (ex 123-123-1234)
 
 
Education, Training and Occupation
   
  Education*     Training* (Hold CTRL for Multiple Choices)
  Age*
    
  Occupation*
    
  Professional Certification (check all that apply)  
 
  First Aid / CPR
  First Responder
  EMT
     
 
 
Occupation Information
 
  Occupation Type     Response Level  
Enter your business address:   Precinct number  
  Address Line 1:     Fire Sta number  
  Address Line 2:     # Engines at your station  
  City     # Trucks at your station  
  State     # ALS – EMS at your station  
  Zip     # BLS –EMS at your station  
 
 
How did you hear about our products?
   
  (check all that apply)        
 
  Television & Radio
  Trade show or Conference
  Search Engine
  Direct Mail
  Email
  Referral or Colleague
 
  Other   (describe below)
   
 
 
  I would like to receive updates about Incident Tactics products,
services and their "ICS Training Tips" Newsletter.
 
Please contact us for more information.