Application for Fire Certification / Search and Rescue Course Completion

 
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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?
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2. Name: FIRST - MIDDLE INITIAL - LAST
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3. MAILING ADDRESS
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4. PERSONAL Email Address
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5. Cell Phone Contact Information AREA CODE XXX XXXX
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6. Date of Birth (MM/DD/YYYY)
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7. PSID # Format: XXXX-XXXX
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8. Course # - Required
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9. Type of Testing
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10. Please choose the correct option below: