Become a Shmirah Coordinator Registration

Join Austin's Last Responder Community. Please fill out the form below to register as a shmirah coordinator for your congregation. The Area Coordinator will confirm with your congregation's leadership that you are authorized for this position.

Email - serves as your user ID *

Password*

Retype Password *

First Name *

Last Name *

Address *

Address2

City *

State *

Zip *

Cell Phone Number *

Second Phone Number

Second Email

Other Affiliation? *

The first backup coordinator serves in the absence of the primary coordinator. The second backup coordinator serves in the absence of the primary and first backup coordinators. The third backup coordinator serves in the absence of the primary, first and second backup coordinators.

Select your coordinator level *

Primary

First Backup

Second Backup

Third Backup or lower

Anything else you'd like to tell us?

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