Public Safety / Government RegistrationWho should register? Fire, EMS, OES, Public Health and any Government Agency that performs a Homeland Security function. Notification e-mail address must be agency affiliated. (Please, no personal e-mail addresses.)
CONTACT INFORMATION(for registration purposes only)First Name *Last Name *Position/Title/Rank: *Phone Work: (###-###-####) *Mobile Phone: (###-###-####) E-mail: * (use agency/organization email address)Address: *City: *Island / State:*Zip code:*WEBSITE ACCESSPassword: *Create a password for site / modify contact information)
AGENCY / ORGANIZATIONAgency/Organization Name: *If your agency does not appear on the above list, complete the Full Agency Name below.Other Agency/Organization Name:Federal State Local Miltary OtherSUPERVISOR / EMPLOYMENT VERIFICATION CONTACTFull Name*Supervisor's Title*Phone Work:* (###-###-####) Supervisor's Email Address:* (Organization email addresses only)Confirm Your Supervisor's Email Address:*
DESCRIPTION OF FACILITY OR NATURE OF BUSINESS* Description is required to substantiate the need for inclusion in the MLRIN
Other Sector (please specify)
2. I hereby acknowledge that I have read the attached document, titled "Safeguarding Sensitive but Unclassified Information" and a copy has been provided to me, and that I have received a security indoctrination concerning the nature and protection of FOUO information, including the procedures to be followed in ascertaining whether other persons to whom I contemplate disclosing this information have been approved for access to it, and that I understand these procedures. I also acknowledge that I have been advised that the MLRIN adheres to 28 CFR (Code of Federal Regulations) Part 23 guidelines, with respect to criminal intelligence files, and will only share criminal intelligence information with other law enforcement agencies that adhere to (same).
3. I have been advised that the unauthorized disclosure, unauthorized retention, or negligent handling of FOUO information by me could cause damage or irreparable injury to the MLRIN. I hereby agree that I will never divulge FOUO information to anyone unless: (a) I have officially verified that the recipient has been properly authorized by the MLRIN to receive it; or (b) I have been given prior authorization from the agency responsible for the information that such disclosure is permitted; or (c) the recipient has the "need to know" in order to perform their official, public safety duties. I understand that if I am uncertain about the classification status or handling control authority of information received from the MLRIN, I am required to confirm from an authorized MLRINofficial that the information is FOUO before I may disclose it, except to a person as provided in (a) or (b) above.
4. I have been advised that any breach of this Agreement may result in the termination of my affiliation with the MLRIN.
5. I have read this agreement carefully and my questions, if any, have been answered.