State Fire School Registration Form
Fire Department Name (*)
Please enter only letters and numbers in this field (alphanumeric).
Chief's Name (*)
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Station Address (*)
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Station City (*)
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Station State (*)
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Station Zip Code (*)
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Station Phone (*)
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Station Fax
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Station Contact Person / Training Officer (*)
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Station Email
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Attendee First Name (*)
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Attendee Last Name (*)
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Attendee Street Address (*)
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Attendee Address City (*)
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Attendee Address State (*)
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Attendee Address Zipcode (*)
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Attendee Home Phone Number (*)
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Attendee Email Address
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In the boxes below, enter in the class codes for the sessions you wish to attend. You can pick:
ONE - 12 hour session, or
ONE 8 hour and ONE 4 hours session
or THREE 4 hour sessions.

If your initial choice is canceled, please enter your second and third choices for the time sessions.
Enter your choices for classes. If you are picking 4 hour or 8 hour classes, make sure to put a comma between the course numbers in each entry field (137, 140, 984)
First Choice
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Second Choice
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Third Choice
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Please submit your registration