Public Safety Classes |

CLASS LIST:

Traffic Incident Management (TIMS)
Basic Fire
Building Construction
Forcible Entry
Fire Life Safety Preparedness
Pump Introduction
Right Seat Ready
Emergency Medical Responder
EMT Boot Camp
A&P for EMS Providers

Traffic Incident Management (TIMS)

Basic Fire

Building Construction

Forcible Entry

Fire Life Safety Preparedness

Pump Introduction

Right Seat Ready

A&P for EMS Providers ONLINE

A&P for EMS Providers ONLINE - 5/19/2020-7/26/2020 - online - $180.00

Emergency Medical Responder

This is a hybrid class with 33 hrs of online didactic and 39 hrs seated.
The seated portion will be on Sat 830-5p & Sun 830-3p for 3 weekends

Medical Responder Initial - 5/19/2020-7/12/2020 - 8:30AM-5:00PM - S,SU - $180.00

EMT Boot Camp

This is hybrid class with 172 hrs seated, 24 hrs online & 32 hrs of clinicals.
Seated portion will be Tue, Wed, Thur 830-5p with a Saturday 830-5pm

EMT Initial Bootcamp - 6/23/2020-8/6/2020 - 8:30AM - 5:00PM - T,W,T - $196.50

SSN OR STUDENT ID NUMBER:*

FULL NAME:*

First Middle Last

ADDRESS:*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

EMAIL ADDRESS:*

HOME PHONE:*

BIRTH DATE:*

ARE YOU HISPANIC/LATINO?*

NO (NHS)
YES (HIS)

RACE (Check one):

White
Black/African American
Native American/Alaska Native
Asian
Hawaiian/Pacific Islander

SEX (Check one):

Male
Female

EMPLOYMENT STATUS (Check one):*

Retired
Unemployed-Not Seeking
Unemployed-Seeking
Full time
Part-Time--Number of Hours Per Week

NO. OF HOURS:

EDUCATION LEVEL (Check only one):*

Completed High School
One-Year Vocational Diploma
Master's Degree
Adult High School Diploma
Associate Degree
GED Diploma
Bachelor's Degree
OR -Highest Grade Completed

GRADE:

CITIZENSHIP (Check one):*

U.S Citizen
Permanent Resident Alien
Non-Immigrant Alien
Other

DEPARTMENT OF AFFILIATION:

Department Type

Firefighter
1st Responder
LEO
Corrections Officer
EMR
EMT
AEMT
Paramedic

STUDENT SIGNATURE:

DATE OF SUBMISSION:*

Certification of Accuracy*

By this check, I certify that the information I have given is true and complete to the best of my knowledge. I further understand that falsification or failure to supply the correct information may be considered grounds for rejection or dismissal. Further, I understand that by submitting this information via electronic transmission that I acknowledge the above statement of certification in lieu of a signature.
Please check:

Yes

Public Safety Classes

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