Email Address *

First Name *

Last Name *

What year did you first receive your NFIP Flood Control Number (FCN card)? Enter N/A if not applicable. *

Flood Control Number (FCN) - Enter N/A if not applicable. *

What is your profession? *

Address 1 *

Address 2

City *

Resident State *

Zip Code (first 5 digits only) *

Phone Number *

Do you want continuing education credit for this course? (Must provide valid license #) *

Designated state for filing CE credit (If you do not want or are not eligible for CE credit, select, "I do not want CE credit") *

License NUMBER (not your FCN) REQUIRED FOR CE CREDIT (If you do not want CE credit or do not have a valid license, enter N/A) *

NPN - Required for CE Credit in AL, AR, DE, NH, OK (If not applicable, or if you do not want or are not eligible for CE credit, enter N/A *

I understand that if any of this information is incorrect or does not exactly match my license record, the state system will not record my CE credits. (If you do not want CE credit, please respond No.) *

I understand I must register under my own name and unique email address to be eligible for CE credit. I cannot use the same login link or email address as any other course takers. *