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PennFIRS On-Line User Registration

PennFIRS On-Line requires authorization from the fire chief or president of the fire company/department.  If registering and you are not the chief/president, please include either contact information in the remarks section below so we can verify and process your department registration.
(*) fields are required to submit the form. Incomplete forms cannot be processed.
Please submit your report information by clicking on the "Save" button at the end of the form. A confirmation pop-up window will appear after submitting your report. Thank you.
County: *
FDID: 5 Digit Number Only *
Fire Department/Company Name: *
Department/Company Street Address (No PO Box): *
Department/Company Mailing Address: *
City: *
Zip: *
Department Phone #: Area Code + Number *
Contact Last Name: *
Contact First Name: *
Fire Department Postition: *
Contact Phone (Day): Area Code + Number *
Contact Phone (Other): Area Code + Number *
Contact Email: *
What reporting software do you currently use: *
If other 3rd party, please list other third party software: