* 1. Official Application for Fire Certification/Search and Rescue Course Completion: Do you understand that all required fields must be appropriately completed or the application will be denied?

* 2. Name: FIRST - MIDDLE INITIAL - LAST

* 3. PERSONAL Email Address

* 4. Date of Birth (MM/DD/YYYY)

* 5. PSID # Format: XXXX-XXXX

* 6. Course # - Required

* 7. Type of Testing

T