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Class Dates Populated via code.
Student Name* NOTE: Enter your name EXACTLY as you would like it to be printed on the class roster and your certificate, including proper spelling and capitalization . We are not responsible for typos!
First
Middle
Last
Date of Birth* Student Address*
Student Email*
Department Information Agency Address*
Financially Responsible Party Please select who is financially responsible for your registration fee and any other applicable fees.
Address of Financially Responsible Party
Billing Point of Contact Email Address Supervisor / Training Officer Name* Name of supervisor, training officer, or other person responsible for approving training requests within your organization.
First
Last
Supervisor / Training Officer Email* Email address of supervisor, training officer, or other person responsible for approving training requests within your organization.
Attendance Policy* All persons failing to withdraw from a class with less than 5 days notice from class start (but greater than 48 hrs notice) will be required to pay 50% of the full registration fee of each course missed. All persons who withdraw from a class with less than 48 hours notice from class start will be required to pay the full registration fee for each course missed. All persons who register for a class and “No Show” or fail to complete the entire class will be required to pay the full registration fee of each course missed and receive a written warning to their sponsoring agency. Continued abuse of this policy will result in suspension of all training privileges. Exceptions to this policy may be made on a case by case basis by the FCPSTC. This policy applies to ALL courses, even those without tuition fees or courses that have had tuition waived due to your agency's participation in our training membership program. For tuition-free courses, a $50 no-show fee will be applied.
To withdraw from a course, please send an email to
info@fcpstc.org . Your email should include your name, your agency, the course name start date, along with the reason for the withdrawal.
I acknowledge that I understand and accept the attendance policy.
Tobacco Use Policy* I understand that smoking and the use of smokeless tobacco is prohibited on the campus of the Franklin County Public Safety Training Center. This includes the use of tobacco products in company-owned or personal vehicles parked on FCPSTC property. I understand that this policy applies to all persons, including but not limited to, visitors, board members, instructors, contractors, vendors, and any other guests on FCPSTC premises. I further understand that persons found in violation of this policy are subject to removal from FCPSTC property, regardless of the completion status of any training programs in which they may be enrolled.
I acknowledge that I understand the Franklin County Public Safety Training Center tobacco use policy.
Liability Release* The Franklin County Public Safety Training Center (FCPSTC) endeavors to provide training consistent with fire/rescue, EMS, EMA, and law enforcement situations that you may encounter in your profession. Even though student safety is a fundamental concern in all aspects of FCPSTC training, at times training activities may be rigorous and physically challenging. The assumption of risk agreement eliminates any misunderstanding as to the risks you may face if you choose to participate fully in this program.
The following statement must be agreed to before your application can be processed.
Assumption of Risk Agreement Yes, I accept the risks involved in the training program to which I am applying. I am able to participate in this training program and am in full compliance with my agency's established medical standards and/or health screening program and I am deemed fit for duty by my agency.
Training Announcement Email List If you would like to be notified of future training opportunities at the Franklin County Public Safety Training Center, please check the disciplines that you are interested in, and you will be added to our training announcement email lists for the selected public safety disciplines. Law enforcement personnel must register using their official government email address .
Active Law Enforcement Status Verification I certify that I am currently employed by a federal, state, or local government agency, or a unit of the U.S. military as a sworn law enforcement officer who is authorized by law to engage in the prevention, detection, detention, apprehension, and/or investigation of felony and/or misdemeanor violations of federal, state, local, tribal, or military criminal laws; a sworn officer serving in parole, probation, or pretrial services for a federal, state, or local government agency; or in a designated Direct Law Enforcement Support Personnel (DLESP) position with a military, federal, state, or local agency, with assigned duties that require knowledge of the subject matter.
I verify that the above statemment is true and correct. I understand that this application will be reviewed by a law enforcement agency, that my active law enforcement status will be verified, and that any false statements made herein are subject to the penalties of 18 PA. C.S., §4904, relating to Unsworn Falsification to Authorities.
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Prerequisites This field is hidden when viewing the form
Student Needs This field is hidden when viewing the form
Class Location