MACC Work Assignments Site - Collect User Info

Fill in this form to create a username and password so you can use this site to pre-register for work assignments.

We need your name (first and last) and your phone number. This will allow us to verify your identity before creating a username.

First Name:
Last Name:
Phone Number:
	(enter all 10 digits of your phone number w/o dashes, spaces or parentheses)
Email Address: