WV Handle With Care Notification App Sign Up Form
The Handle with Care Notification application is for West Virginia first responders only. Use this form to request access to submit Handle with Care notifications in West Virginia. Please allow up to 48 hours to process.  Be sure to use a business email address during signup (do not use Gmail, Hotmail, Yahoo, etc.)
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Email *
First Name
*
Last Name
*
Title
*
Organization
*
Cell Number *
Please provide your cell number to receive verification codes. Phone number must contain digits only.
Type of Responder
*
Counties Served
*
Required
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This form was created inside of HWC Notice.

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