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STEP ONE

(Items marked with * required)

	*This is: (select one)

	CONTACT INFO:
		Please be sure that the below information reflects how your name appears on your credit card and is your billing address
	*First Name:
	*Middle Initial:
	*Last Name:
	*Emergency Agency Affiliation:
	Your Email Address:
	*Billing Address:
	*City:
	*State:
	*Zip:
	*Contact Phone Number:

	CREDID CARD INFO:
	*Type of Credit Card:
	*Credit Card Number:
	*Expiration Date:	Month: Year:

	SUBSCRIPTION:
	*Subscription Choice:
	*Wireless Device Carrier:
	Wireless Device Number:
	Promo Code:
	Comments:

	*I will not use CFP for any commercial purposes (this is a personal account).
	I have read and agree to the CAROLINAS FIRE PAGE* Terms of Use.

	You will be able to customize your group alert options on the next screen.