RegisterLethality Assessment Program

First Name

Last Name

User ID

Please don't use the characters !, &, ", ', or ()

Select Agency

(Departments/Sheriffs select your Town/Sheriff Office, Domestic Abuse Agencies select your Agency.)

(Sheriff’s Offices are at the bottom of the list.)

(Please be aware that your jurisdiction may be listed as a City of… Town of… or Village of… as applicable.)

(In the case of multiple towns in Wisconsin with the same name, they will be listed as: Town_County)

Telephone Number

(Please enter just 10 numbers ##########, no -)

Email

(Please enter a valid Email address jsmith@email.com)

Password

(Minimum 6 to Maximum of 16 characters)

Confirm password

(Must be the same as the password above)

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