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Arkansas Division of
Emergency Management

Division of Emergency Management
- Training & Exercise
  - Training
    - Class Registration Request

Home > Emergency Management Top Level > Division of Emergency Management > Training & Exercise > Training > Class Registration Request

Class Registration Request

STOP!!! DO NOT GO ANY FURTHER TILL YOU HAVE READ THIS! If you are registering for a training course please click on the following link: Training Schedule or Earthquake Course Schedule. You must select a course with a date and time listed on the schedule.

ADEM – Class Registration Request

This form is only for you to request being added to a class, this does not guarantee that you will get into the class. Once you have submitted this request, if you are accepted into the class, you will get an email informing you that you have been added to the class.
Name*
First Last
Name of the Person Taking the Class.
FEMA Student ID Number*

Enter your FEMA ID
Last 4 SSN:*

Enter the last 4 numbers of your SSN
Organization*

Name of the Organization the person being registered for the class is with.
Email*

Email Address of the Person Taking the Class or an Email Address they can be reached at.
Phone*
Phone Number of the Person Taking the Class or a Phone Number they can be reached at.
Organization Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Address of the Organization that the person taking the class is with.
Class Name*

Full name of the class being requested.
Date*
MM slash DD slash YYYY

Start Date of the class being requested.
Class Location*

Location of the class being requested.
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Contact ADEM

Building 9501
Camp Joseph T. Robinson
North Little Rock, AR 72199
501-683-6700
Contact Form

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