ENP Retired Application · Complete this application for ENP Retired Certification and send...

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Emergency Number Professional (ENP) Retired Application Form APPLICANT INFORMATION Name _______________________________________________________________________ Mailing Address ______________________________________________________________ City/State/Zip ________________________________________________________________ Phone _______________________________________________________________________ Email ________________________________________________________________________ I certify that I am retired from the emergency communications industry and that I have re-certified as an Emergency Number Professional a minimum of two times. I became an ENP in (____/____) and my effective retirement date is/was _____________________. I also understand that if I return to work full-time in the emergency communications profession, I may no longer use the ENP Retired designation. Signature_____________________________________________ Date___________________ Complete this application for ENP Retired Certification and send paperwork to: * NENA,1700 Diagonal Road, Suite 500, Alexandria, VA 22314 7 Fax completed application to 202.618.6370 @ Email completed application to [email protected] There is no fee to become ENP Retired.

Transcript of ENP Retired Application · Complete this application for ENP Retired Certification and send...

Page 1: ENP Retired Application · Complete this application for ENP Retired Certification and send paperwork to: * NENA,1700 Diagonal Road, Suite 500, Alexandria, VA 22314 7 Fax completed

Emergency Number Professional (ENP) Retired Application Form

APPLICANT INFORMATION Name _______________________________________________________________________ Mailing Address ______________________________________________________________ City/State/Zip ________________________________________________________________ Phone _______________________________________________________________________ Email ________________________________________________________________________ I certify that I am retired from the emergency communications industry and that I have re-certified as an Emergency Number Professional a minimum of two times. I became an ENP in (____/____) and my effective retirement date is/was _____________________. I also understand that if I return to work full-time in the emergency communications profession, I may no longer use the ENP Retired designation. Signature_____________________________________________ Date___________________ Complete this application for ENP Retired Certification and send paperwork to:

* NENA,1700 Diagonal Road, Suite 500, Alexandria, VA 22314 7 Fax completed application to 202.618.6370

@ Email completed application to [email protected]

There is no fee to become ENP Retired.