Class Registration

Use the form below to register for Fire-Rescue Academy course offerings. It is necessary to submit a separate form for each class request.

Fields marked with >> are required.

Student Information

Last Name>>

First Name>>

Social Security Number>>

Last four digits ONLY

Student E-mail Address>>

Career/Volunteer ID Number

Last six digits ONLY

Home Telephone Number>>

Include dashes (Example XXX-XXX-XXXX)

Station Information

Station Name>>

If 'Other' please specify below.

Other Jurisdiction

Please specify

Shift

Career Only

Courses

Course Offerings>>

ALS Offerings

Company/Training Officer Information

Company/Training Officer>>

Company/Training Officer E-mail>>