Rensselaer County Fire Chiefs Association

Fire Training Registration Form

STATE FIRE COURSES PRE-REGISTRATION

 

COURSE NAME:  _______________________________________

 

LOCATION:  ___________________________________________

 

START DATE:  _________________

 

FIRE DEPARTMENT:  ________________________________________

 

PRINT STUDENT’S NAME:  ____________________________________

 

 

1)______________________________________________

 

2)______________________________________________

 

3)______________________________________________

 

4)_______________________________________________

 

5)_______________________________________________

 

6)________________________________________________

 

7)________________________________________________

 

8)________________________________________________

 

9)________________________________________________

 

10)________________________________________________

 

 

_________________________________

Department Chief or Training Officer

 

______________________________

Contact Telephone Number

 

Firefighter I course:  New Members to have first selection

 

Host Company will have first selection

 

If you sign up and do not take the course you will not be able to sign up for any other course during the current training year. (April-March)

 

 

MUST BE FAXED (518-270-4164) THREE WEEKS BEFORE START DATE. Also E-mail to marehal@fairpoint.net

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