2. 
4. First Name*
5. Last Name*
7. Phone Number (###-###-####)*
8. Agency*
10. Email Address
    If you have an Email address please fill this field out.
12. County Asset Tag Number
    The number on the white Cortland County sticker.
13. MDT Windows Username*
    The username you use to sign onto the MDT
15. Apparatus *
    The apparatus the MDT is located in.
16. MDT General Issue*

    1. Physical
    2. GPS
    3. Mifi
    4. Connectivity
    5. Log In / Passwords
    6. Spillman
    7. Other
18. Please provide a detailed description of the problem...*
20. When you click send you will be redirected to the Emergency Response & Communications homepage.
Leave This Blank:


22. 1. Receive an email copy of this form.
23. Email address

    This field is not part of the form submission.

24. Submit

* indicates a required field