2019 Open Enrollment Flashover

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FULL TURNOUT GEAR and SCBA REQUIRED - STUDENTS MUST BE FIREFIGHTER 1 CERTIFIED

Sunday, March 31, 2019- 8 am - 4 pm

Fairfield Regional Fire School
205 One Rod Highway, Fairfield, CT 06824
$120 per student includes lunch

An electronic invoice will be emailed. You can choose to pay by check, electronic check, or credit card. Checks should be made payable to F.R.F.S.

NOTES FOR FRFS STAFF

First Name *

Last Name *

Street Address *

City *

State *

Zip *

Primary Email *

Secondary Email

Home Phone

Cell Phone *

Department Affiliation *

Department Authorization to Attend Training *

Once your application is received, an email will be sent to your Chief or Supervisor listed above for their approval to take the class. No student will be enrolled without consent from their sponsor department.

Yes, I understand my application will not be accepted until my Chief or Supervisor approves my enrollment based on the conditions spelled out in their agreement which will be emailed to them.

Required

Authorizing Supervisor's Name *

Authorizing Supervisor's Email *

Authorizing Supervisor's Phone Number *

Firefighter I certified? *

Yes

Required

Method of Payment *

$120 per student

Purchase Order To Follow

Bill My Department

Bill Me, I understand payment must be received before class begins. An electronic invoice will be emailed. You can choose to pay by check, electronic check, or credit card. Checks should be made payable to F.R.F.S.

Required

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