Account Request Form

*Fields that are required

Accounts Needed:

Please check all that apply. If unsure, they can always be created later.

WebEOC
GIS
GMS

*Last Name:

Please do not add suffixes, for example “III”, “Jr.” ”, etc.

Enter Last Name

*First Name:

Please do not add a middle initial.

Enter First Name

*Email:

Please provide a work email. Use of a personal email account will possibly delay or prevent approval of the account.

*Phone: "xxx-xxx-xxxx"

Please provide a work phone number, where you can be reached.

*Please select Agency or County:

Texas State Agency List

Texas County List

Enter Your Agency or County Name

*Texas State Agency List:

Please select an Agency.

*Your Message:

Please provide information regarding the access you will need in WebEOC. Also provide your job title, supervisor, agency of employment or agency you are assisting.

Enter Your Message

Possible Approver:

Please provide the Account Approver email, if known. Otherwise leave this blank.