EMA Register Form

EMA Request for Secure Access

* Answer is required

Secure Access Request Form

Please fill out the information below to request access to the Dauphin County EMA Secure Section.

1.	Full Name *

2.	Department Name *

3.	Department Affiliation *

4.	Department Director's / Manager's Name *

5.	Phone Number 1 *

6.	Phone Number 2

7.	Email Address

9.	Password Preference *

11.	Justification for access into the areas which you have asked for permission *

County News

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County of Dauphin, Department of Information Technology

2 South Second Street, Fifth Floor
Harrisburg, PA 17101-1295