Account Application for University/College Affiliation

Complete ONLY if you are affiliated with a University or College. If you are affiliated with a Fire Department, click the browsers back button and choose FIRE DEPARTMENT AFFILIATION

Registration Details
User Name:

User Name needs to contain a minimum of 5 characters. Only letters, numbers, and underscores are allowed.


Password needs to contain a minimum of 7 characters. Only letters and numbers.

Confirm Password:  
Confirm Email:  
First Name:  
Last Name:  
Job Title:  
College/University Affiliation:

Main location for this account

Address 1:  
Address 2:  
Campuses you are responsible for:

IMPORTANT ... Type the City or Town where each of your campuses are located. Separate with a comma. These locations will appear as your personal "selection" list in the future when you are completing an incident report.

Are you a member of the Center for Campus Fire Safety? If not, click to visit our site and learn more:
Have you attended our free Firewise Campus Instructor Training? If not, click to visit our site and learn more:
Would you like to receive our free monthly newsletter, Campus Firezone? To receive future newsletters click: and sign up to be included in our mailing list. To download previous issues visit:
Affilation Logo Image must be a jpg file.
About Affilation  

© 2009 The Center for Campus Fire Safety

Main | Contact-Us | About-Us | Help-with-this-website |