FIREFIGHTER TRAINING COURSE
FOTP 800
Print Form
APPLICATION FORM
COURSE NAME
DATES
TUITION FEE
Crestg Member $350.00
Non Crestg Member $400.00
May 2,3,9,10, 2015
FOTP - 800
Payment of the tuition fee must be made on or before the first day of the course. Payment made out to Turner Valley Fire Department, in
the form of a P.O., cheque, money order, or cash. The course will be Turner Valley Fire Station 102 Royal Avenue promptly at 0800
hours on the first day, and all subsequent days scheduled, and shall finish at approximately 1700 hours. Lunch will be one hour and will
be the responsibility of the student. The exam will be on May 10, 2015.
Home Address
Name of Applicant
Postal Code
Home PH
E-mail
Fire Department
Length of Service
Fire Dept. Address
Postal Code
Fire Dept. Phone
Fax Number
Fire Chief/Training Officer Signature
Name/Title (print)
It is expressly understood that the Turner Valley Fire Department, and the Calgary Regional Emergency Services Training
Group (CRESTG), its directors, officers, employees, agents, students, volunteers, and independent contractors shall assume
no liability for any actions resulting from the presentation of any sponsored or prepared course. The Turner Valley Fire
Department will conduct the course according to accepted norms and practices, including NFPA 14043 Live Fire Training
Standard and in such a manner as not to violate any local regulations, resolutions, municipal bylaws, and provincial and/or
federal legislation.
Some elements of this program physically demanding. If the supervisor or the applicant have any concerns about the
applicants ability to do any of the following activities, both with and without wearing breathing apparatus and personal protective
equipment weighing at least 27kg, you must contact the Training Officer as noted below to provide additional relevant
information at the time of submitting the application form.
I have read and understood the preceding caution on behalf of the applicant named.
Authorized Signature:
Name/Title (print)
I agree to be solely responsible for any injury, loss or damage which I might sustain while participating in any program, course/
series due to any cause whatsoever and I agree to release the Turner Valley Fire Department, and the Calgary Regional
Emergency Services Training Group (CRESTG) its directors, officers, employees, agents, students, volunteers, and independent
contractors of all responsibility for such injury, loss or damage. If admitted, I agree to comply with all rules and regulations of
CRESTG and the Turner Valley Fire Department. I certify that all statements on this application are true and complete and that
no information has been withheld. I understand that any misrepresentation of this information may result in the cancellation of my
admission or registration status and that falsifying documents or information on the application may result in immediate
permanent dismissal from the Calgary Regional Emergency Services Training Group. Completion of this signed application
permits the Turner Valley Fire Department, and CRESTG to request and/or confirm any information necessary to support my
application for admission.
In signing this application for admission, I understand that this information, along with subsequent information placed in my
student records will be used for the purposes of admission, registration, research, development, and other purposes consistent
with the mandate of CRESTG. CRESTG also reserves the right for the Board to share information with the Alberta Fire
Commissioners Office, the Alberta Emergency Management Agency and/or other related government agencies. CRESTG further
reserves the right for the Board to share information with post-secondary institutions in situations where an applicant has been
found to have falsified documents or other information on their application for admission. The use of this information will be kept
in compliance with the Freedom of Information and Protection of Privacy Act. I have read and understand all the above
statements.
I HAVE READ AND UNDERSTOOD THE PRECEEDING CAUTION ON BEHALF OF THE APPLICANT NAMED.
Date:
Applicant's Signature:
For further information, Contact Deanna Hintze Deputy Chief/Training Officer
Phone : (403) 933-5553
Fax: (403) 933-4443
Email: [email protected]
Mailing Address for Payment: Turner Valley Fire Department P.O. Box 330, Turner Valley, Alta, T0L-2A0
Turner Valley Fire Department reserves the right to cancel any course.
All applications are considered on a first come first serve basis
(Any applications missing information may not be considered at time of class selection)