Get Request For Instructor Login - Mississippi State Department Of Health

Filling out the Request For Instructor Login form for the Mississippi State Department of Health is essential for course coordinators and instructors seeking access to the EMS Instructor section. This guide provides a step-by-step approach to completing the form accurately and efficiently.

Follow the steps to complete your login request form.

1. Click the ‘Get Form’ button to access the online form and open it for editing.
2. Begin by providing your first name in the designated field. Ensure it is spelled correctly as it will be used for your login credentials.
3. Enter your middle initial if applicable, followed by your last name in the corresponding fields.
4. Fill in your address details. This includes Address 1 and Address 2 if necessary, followed by your city, state, and zip code.
5. Specify your home county accurately to ensure proper identification.
6. Provide your email address, ensuring it is valid for receiving login information and further communication.
7. List your phone numbers in the designated fields, entering the primary and secondary contact numbers, respectively.
8. Include your fax number if applicable, for any formal communications.
9. Indicate the primary institution or agency where you teach or coordinate. This information is essential for validation purposes.
10. If applicable, list any other institutions or agencies where you are teaching.
11. Provide a list of the courses you regularly teach to provide context for your login request.
12. After ensuring all fields are filled out correctly, save your changes. You may then download, print, or share the completed form as required.

Complete your instructor login request form online today!