Training Membership Program Host Application | Franklin County Public Safety Training Center (FCPSTC)

This host application is for the use of FCPSTC Training Membership Program subscribers only. Members may host up to 80 hours of non-certification training at their station or other off-site location annually and attend courses offered by the FCPSTC at no additional cost for registrations. Certification testing, student manuals, or other items required for the classes are not included with this membership program and are the responsibility of the either the student or the sponsoring emergency services agency.

If your department is not currently a subscriber and would like additional information on the program, please contact the fire training coordinator at training@fcpstc.org.

Non-members may also host FCPSTC training at their stations. Normal registration fees will apply, and there is no limit on the number of classes or the number of hours that may be hosted. Non-members may request to have one or more FCPSTC courses held at their stations or at the FCPSTC using the “Training Request” tab on the FCPSTC website. Certain restrictions may apply. Please contact our fire training coordinato r for additional details.

Training Membership Host Application

Training Membership Program Subscriber?*
Is your department an active participant in the Franklin County Public Safety Training Center Training Membership Program for the current program year?
- Yes
- No
Bucks County Training Membership Program Participant?*
Does your department have an active Bucks County Community College Training Membership Program?
- Yes
- No
Source of Training Hours
Which training membership program will you be utilizing to provide the training hours for this host request?
- FCPSTC Training Membership
- Bucks County Community College Training Membership
- Neither - Pay By Course
Agency Name*
Other Agency Name
Agency Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Requestor Name*
First Last
Requestor Title
Requestor Title - Other
Requestor Email*
Enter Email Confirm Email
Requestor Phone*
Course Title*
Please enter the name of the course you are interested in hosting
Bucks County Community College Course Number*
Please enter the Bucks County Community College course number from their course catalog.
Course Hours*
Total number of course hours
Dates & Times*
Please enter the dates and times of the requested training. For classes that span multiple days, please enter the preferred date, start time, and stop time for each day.
Date Start Time End Time
Classroom Training Location*
Where would you like the training to be held?
Classroom Location
Location of classroom instruction

Street Address Address Line 2 City State ZIP Code
Practical Exercise Location
If the class you are requesting to host has a practical exercise component, please select whether the practical exercises will be held at the training center, the same off-site location as the lectures, or at another location.
Live Fire Practical Exercises?*
Does this training activity involve the use of any live fire practical exercises?
- Yes
- No
FCPSTC Practical Exercise Areas
Please check the areas of the FCPSTC facility that will be required for your training event.
- Burn Building
- Air Cascade System
- Burkholder Building
- Forcible Entry Simulator
- Roof Simulator
- Vehicle Extrication Pad
- Propane Simulator
- Dumpster Fire Prop
Practical Exercise Address
Location of practical exercises

Street Address Address Line 2 City State ZIP Code
Host Site Special Requirements*
Are there any special requirements for your host site that members from other agencies should be made aware of (i.e., mask mandate, proof of vaccination requirement, tobacco-free facility, etc.)?
- No
- Yes
Host Site Special Requirement Details
Please provide details for any special requirements for your host site that members from other agencies should be made aware of (i.e., mask mandate, proof of vaccination requirement, tobacco-free facility, etc.).
Instructor Preference*
- No Preference (First Available)
- I Have A Preferred Instructor
Preferred Instructor Name*
First Last
Preferred Instructor Email
Enter Email Confirm Email
Phone
Number of Expected Attendees
Please enter a number from 1 to 60.
Student pre-registration
If you would like to pre-register members of your agency for this course before the course is advertised publicly, please enter the student information in the fields below. Click the + sign to add additional students.
First Middle Last Suffix D.O.B. Email Confirm Email
Cancellation and Attendance Policy*
As of 1 Jan 2017, 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 FCPSTC courses, regardless of venue, including 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 $25 no-show fee per violation will be applied. To withdraw yourself or a member of your agency from a course, please send an email to info@fcpstc.org . Your email should include your name, your agency, the student's name and agency, the course name start date, along with the reason for the withdrawal. I acknowledge that I understand and accept the attendance policy and have made my members aware of the same.
I have confirmed with my members who are enrolling in this training program that they agree to the FCPSTC Cancellation and Attendance policy. I have made my members of aware of this policy and have confirmed that they understand and agree to abide by this 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 (available for review at fcpstc.org/aor) 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.
I accept the risks involved in the training program to which I am enrolling my agency members. I have made my members aware of these risks and have confirmed that they accept these risks. I also affirm that each member I am enrolling in this training program is in full compliance with my agency's established medical standards and/or health screening program and is deemed fit for duty by my agency.
Additional information / comments
Training Request Procedure*

1. Following the submission of this form, your request will be routed to our fire training coordinator, who will confirm instructor availability for the course and add course to our training schedule once approved by BCCC.

2. The requesting department must meet any minimum enrollment thresholds established by the training provider for all requested training.

3. The requesting department is responsible for providing required equipment, supplying all expendable items, and providing acceptable training sites for both the classroom and practical instructional components of the requested training program(s).

4. The lead instructor for the course must approve of any off-site practical training locations.

5. Neither the requesting department nor any other member agencies attending the course will be invoiced for the course by the Franklin County Public Safety Training Center.

6. The FCPSTC will handle all registrations, advertising, and invoicing of non-member agencies for the requested course.

7. The host agency shall be afforded the opportunity to pre-register as many of their members as they wish, up to the maximum enrollment threshold for the course. Any additional available seats will be advertised to other agencies.

8. If you wish to make changes to your host application following the submission of the application, please contact the FCPSTC via email at info@fcpstc.org.

9. CONFIRMATION: Once the course is approved by BCCC, you will receive an email confirmation from the FCPSTC, along with a training announcement for the course, for your internal use and distribution to other agencies. The FCPSTC will also advertise the course using FCPSTC resources.

I understand the training request procedure and wish to submit this request..
Training Membership Program Inquiry
Please complete the fields below with your contact information, and our fire training coordinator will contact you to discuss our training membership program.
Name*
First Last
Agency Name*
Agency Address*
Street Address Address Line 2 City State ZIP Code
Agency Phone*
Other Phone
Email*
Enter Email Confirm Email
CAPTCHA
Phone
This field is for validation purposes and should be left unchanged.

Date	Start Time	End Time

First	Middle	Last	Suffix	D.O.B.	Email	Confirm Email

Training Membership Host Application

Training Membership Program Inquiry