Instructions

To apply for an account:

- Complete this form and click Submit. All fields are required unless otherwise noted.
- The ICC will email your Point of Contact to verify your information.
- When the information is confirmed you will receive an email with instructions on how to access the portal.

NOTE: International requests will only be processed for DHS Approved Locations. By requesting an account on IMPACT, you are explicitly giving consent for your contact information to be provided to the government organization vetting researchers for your respective country.

Step 1: Create a User Name and password

Please provide your preferred User Name. We will make every effort to use this name when your account is approved, but duplicate names are not permitted.

User Name

Password

Re-Enter Password

Step 2: Provide your information

First Name

Last Name

Title (Optional)

Office Phone

Cell Phone (Optional)

Alternate Phone (Optional)

Fax (Optional)

Alternate Email (Optional)

Please provide your contact information where the research is being conducted.

Location of Research

Street

City

State / Province

Zip

Step 3: Organization Information

Organization

Street

City

State

Zip

Country

Step 4: Authorization Rep Information

Note: An Authorized Representative is someone at your organization who can verify your cyber security research and must be someone other then yourself.

First Name

Last Name

Phone

Step 5: How can we help?

Comments (optional)