Pumps 2

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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

Student Title

Student Title (Other)

Date of Birth*

Student Address*

Street Address Address Line 2 City State ZIP Code

Student Email*

Enter Email Confirm Email

Student Phone*

Department Information

Agency Representing*

If your agency is not listed, please select "Non-Association Member" to enter your agency's information. If you are not a member of a public safety agency and wish to register for one of our classes, please contact us to discuss your options. Please note that private registrations are not accepted for most of our classes.

Agency Name*

Please enter the name of the agency / department that you are representing.

Agency Address*

Street Address Address Line 2 City State ZIP Code

ORI

(Required for classes that are restricted to law enforcement. Invalid entries will be rejected)

Financially Responsible Party

Please select who is financially responsible for your registration fee and any other applicable fees.

Agency

Other (Relief Association, etc.)

Name of Financially Responsible Party (Relief Association, etc.- MUST BE AN ORGANIZATION)

Address of Financially Responsible Party

Street Address Address Line 2 City State ZIP Code

Billing Point of Contact

This is required for all courses, even those without registration fees, in the event there are "no shows" or "late withdrawals". If attending privately and not representing a public safety agency, please list yourself as the billing point of contact.

Billing Point of Contact Phone Number

Billing Point of Contact Email Address

Enter Email Confirm Email

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 Title*

Title of supervisor, training officer, or other person responsible for approving training requests within your organization (i.e. Chief, Deputy Chief, Asst. Chief, Lt. Capt. Sgt. etc.).

Supervisor / Training Officer Phone Number*

Phone number of supervisor, training officer, or other person responsible for approving training requests within your organization.

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Supervisor Email (In Network)

Pre-populated by training officers in site options.

Supervisor / Training Officer Email*

Email address of supervisor, training officer, or other person responsible for approving training requests within your organization.

Enter Email Confirm Email

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Course Attendance Status

If attending training privately, and not at the request of any public safety agency, the student acknowledges that he/she is in compliance with his/her agency rules and regulations regarding off-duty activities and also acknowledges that he/she is attending this course in an off-duty status for the purposes of insurance, liability, and workman's compensation and other work-related statutes and administrative regulations. Additionally, if attending on his/her own time, and not at the request of his/her agency, the student acknowledges that he/she is also financially responsible for any course tuition and fees associated with this training program. By completing this application, the student acknowledges this policy. Please indicate below whether you will be attending privately, on your time, or if you will be attending as a member of an organization and will be considered to be in an on-duty status during your participation in this training program.

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.

Fire

EMS

Emergency Management

Law Enforcement (Must be vetted LEO)

ORI*

Please enter your agency's ORI. If you do not have one or do not know what that is, you are not eligible to receive our law enforcement training announcements. All ORIs will be verified. Invalid or incomplete entries will be discarded. Attempts to access law enforcement sensitive information by unauthorized personnel will be referred to the appropriate authorities for potential criminal prosecution.

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Prerequisites

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Student Needs

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Class Length

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Registration Fee

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Minimum Age

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Class Location

Class Details

State Certified Course?

Registration

Prerequisites

Student Needs

Department Information