Maryland Responds:

Registration

For the best experience, do not use the refresh, stop, back or forward buttons on the browser and only single-click buttons within a page.
An asterisk (*) indicates a required field. You will be alerted if the required information has not been entered.
For your security, all communications are encrypted and you will be logged out automatically if you are inactive for more than 60 minutes.
We recommend the latest version of Microsoft Edge, Mozilla Firefox for Mac or PC, Apple Safari for Mac or PC or Google Chrome for Mac or PC with JavaScript enabled and pop-up blocker turned off to use this site. Please see your browser's help file for more information.

Organizations

Organizations represent your Maryland Responds Unit affiliations. Upon registration, you automatically become a member of, and affiliated with, the Maryland Responds MRC State Program organization. In addition, you will select one Local Unit based on your county of residence. If you live outside the state of Maryland, please select the "Maryland Responds MRC State Program" as your Local Unit organization. Click the "Add Organizations" link below to select your Local Unit organization.

Add Organizations

Organization(s):

Account Information

Creating an account is the first step in the Maryland Responds registration process. You will use your account username and password each time you log into Maryland Responds.

Username:

The username must be at least six (6) characters long and cannot contain spaces. Acceptable characters include alphanumeric (A-Z, 0-9) and the symbols @, ., -, and _. Usernames are not case sensitive.

Password:

Confirm Password:

Secret Question:

Secret Answer:

Terms of Service and Privacy Policy

Required field Terms of Service:

By checking this box, I indicate that I agree to the Terms of Service and have read and understand the Privacy Policy for this site. My submission of this form will constitute my consent to the collection and use of this information and the transfer of this information across the Internet to processing and storage facilities supporting this system. I also agree to receive required administrative and legal notices such as this electronically.

Required field Information Pledge:

By checking this box, I certify that I will provide only correct information when completing this registration process. I also give consent to Maryland Responds and their designated agents to collect, use, verify, and maintain any information that is collected through the use of this site.

Required field Authorization:

I do hereby authorize the State of Maryland to research and copy records including, but not limited to, educational, professional, judicial; armed services; Federal, state and local law enforcement; motor vehicle and driving safety; and any other documents, data, and information that may be necessary and practical in order to conduct an investigation; and to contact past and present employers as well as professional references for information. I also authorize the release of the above mentioned records to the State of Maryland. My consent, however, is conditioned upon the understanding that all records, data, and information obtained by the State shall be used only for the purposes of determining my fitness for the volunteer position(s) to which I am assigned.

Name and Address

First Name:

Middle Name:

Last Name:

Address Line 1:

Address Line 2:

City:

State:

County:

Zip Code:

Work State:

Alternate Address Line 1:

Alternate Address Line 2:

City:

State:

County:

Zip Code:

Identifying Information

Date of Birth:

Contact Information

Primary Email Address

Delete

Email Address:

If you have an email account, it is important for you to provide this information. Without your email address, you may miss important messages and notifications. Please note that the system will not allow two accounts with the same email address. If you do not have an email address or your email address is already registered with the system, you can learn more about obtaining a free email address by clicking here.

Confirm Email Address:

Add Email Address

Contact Method 1

Delete

Contact Method 1:

Number to Attempt:

Pager Type:

Pager Carrier:

Pager ID/PIN:

Add Another Contact Method

Occupation Information

What is your occupation type?

Occupation:

If your occupation does not appear in the list, please select Other.

What is your current professional status for this occupation?

Professional License

Please provide the responder's license information for the occupation above

Is the name on the responder's license the same as the name provided in his or her personal information?

Yes No

License Number:

Professional License number, exactly as it appears on the license.

Issuing State or Jurisdiction:

State or jurisdiction in which this license was issued.

Expiration Date:

Required field Is the responder's license in good standing?

Yes No

Required field Is the responder's license free of adverse actions and restrictions?

Yes No

Registration Feedback

How did you hear about the site?

If Other, please specify in the comments.

Comments: