2014 REVISED: DECEMBER

Transcription

1 Revised: Oct 2014 REVISED: DECEMBER 2013

2 Alabama Fire College and Personnel Standards Commission To Prospective Recruit School Candidates: We are pleased that you are considering a career in the fire service. Our profession is among the world s most noble. Our mission in recruit training is to teach individual firefighter candidates the knowledge, skills, and abilities needed to perform the tasks needed to begin their careers. Further, we incorporate teamwork and a strong sense of esprit de corps into each individual mind set. We do not take this mission lightly, and ask that each candidate bring values of honor, integrity, and workmanship to their entry into recruit training. Recruit training is not for all individuals. The program consists of nine weeks of intense training that involves both the mental and physical capacities of the trainee. The program begins with the teaching of individual skills and progresses into increasingly more demanding skills toward the end of the school. The program is designed to increase the fitness level of the recruit before commencing with more intense firefighting training. It culminates with scenario-based training at which time all of the cumulative knowledge, skill, and abilities gained will be required to successfully complete the program. Prior to entry, we encourage all candidates to begin preparation both mentally and physically as the administration of tests will begin within the first week of class along with the commencement of physical fitness training evolutions. Enclosed you will find the paperwork necessary to apply for the training program. Certainly, if you have questions that remain after reviewing the material please do not hesitate to contact Student Services. Again, we look forward to seeing you in recruit training. We will be committed to providing you quality training as you seek to begin your career. Student Services 1(800) studentservices@alabamafirecollege.org

3 MINIMUM PRE-REQUISTES AND ADMISSION CRITERIA: Must be turned in prior to Orientation. 18 years of age Copy of high school diploma, GED or transcript. If using VA benefits: official transcripts from all schools attended, including military and a certificate of eligibility and transfer of training programs must be included (VA Form ). Verification of current CPAT (cannot be over one year from start date of class) Current, valid certification or proof of successful training for: Emergency Medical Responder, Emergency Care Provider, or EMT training. Proof of health insurance card (copy of card front and back) Copy of driver s license (front and back) Physical Statement form including Essential Functions of Fire Fighting (cannot be over one year from start date of class) Physical Examination form (cannot be over one year from start date of class) with proof of up-to-date Tetanus and Hepatitis B vaccinations Notice of Employment (if hired by a paid department) Completed application Also required for Fire Fighter Bridge: Certified Volunteer Fire Fighter Certified Hazardous Materials: Awareness and Operations

4 On-Campus Recruit School Uniform & Equipment List *PERSONAL PROTECTIVE EQUIPMENT (PPE) RENTAL FEE ($700) INCLUDES: turnout coat, turnout pants, helmet, gloves, boots, Nomex hood, and Self- Contained Breathing Apparatus (SCBA) with spare bottle. This fee is non-refundable and is payable at the Registration office. This option is available on-campus only. MINIMUM REQUIRED for SELF-SPONSORED APPLICANTS: Three (3) navy t-shirts with white AFC logo Three (3) pairs of navy PT running shorts with AFC logo One (1) navy sweatshirt with white AFC logo One (1) pair navy sweatpants with white AFC logo Three (3) pairs of navy BDU pants Three (3) navy golf shirts with AFC logo One (1) black, cotton belt Textbook GRADUATION UNIFORM: One (1) long sleeve, gray dress shirt with AFC patch One (1) navy tie One (1) pair of dress pants, navy with red stripe One (1) AFC badge ITEMS NOT INCLUDED: One (1) pair of running shoes One (1) pair of black boots or dress shoes *PPE MINIMUM REQUIRED for DEPARTMENT-SPONSORED APPLICANTS: Department-issued uniforms for daily wear Department-issued dress uniform for graduation *PPE Three (3) navy PT t-shirts with AFC logo Three (3) pairs of navy PT running shorts with AFC logo One (1) navy sweatshirt with white AFC logo One (1) pair of navy sweatpants with white AFC logo One (1) pair of white or black running shoes Textbook Regional Training Center Recruit School Uniform & Equipment List *PERSONAL PROTECTIVE EQUIPMENT (PPE): To order, contact the Regional Coordinator assigned to the RTC where Recruit School is being held. MINIMUM REQUIRED for SELF-SPONSORED APPLICANTS: Three (3) navy t-shirts with white AFC logo Three (3) pairs of navy PT running shorts with AFC logo One (1) navy sweatshirt with white AFC logo One (1) pair navy sweatpants with white AFC logo Three (3) pairs of navy BDU pants Three (3) navy golf shirts with AFC logo One (1) black, cotton belt One (1) AFC badge (for graduation uniform) One (1) AFC patch (for graduation uniform) Textbook ITEMS NOT INCLUDED: One (1) pair of running shoes One (1) pair of black boots or dress shoes *PPE Graduation uniform: A badge and patch may be purchased from the Bookstore at 1(866) The host department affiliated with the recruit school will provide the student with information regarding the graduation uniform at the beginning of the Recruit School. Required uniform for graduation will include: One (1) long sleeve, gray dress shirt One (1) navy tie One (1) pair of dress pants, navy with red stripe MINIMUM REQUIRED for DEPARTMENT-SPONSORED APPLICANTS: Department-issued uniforms for daily wear Department-issued dress uniform for graduation *PPE Three (3) navy PT t-shirts with AFC logo Three (3) pairs of navy PT running shorts with AFC logo One (1) navy sweatshirt with white AFC logo One (1) pair of navy sweatpants with white AFC logo One (1) pair of white or black running shoes Textbook Badges, patches, BDU pants, golf shirts, and PT gear are available for purchase at the AFC Bookstore on the main campus in Tuscaloosa and can also be ordered by calling 1(866) or online at afcbookstore.com.

5 Payment Information Full payment is due at the time of registration. Withdrawal/Refund Policy Students who register for a course and wish to withdraw in good standing must submit a written request by to studentservices@alabamafirecollege.org, to be received at least two weeks prior to the beginning date of the class. A written withdrawal received according to the stated time limit will result in a full refund. If you fail to withdraw in the allotted time, you/your department/your agency will not receive a refund. There is no refund given for PPE rental. There is a $175 penalty for withdrawal from Fire Fighter I/II after Orientation has been held, providing the student has withdrawn before the first day of class, in addition to: First week withdrawal: Students, both FF I/II and Bridge, withdrawing during the first week of class will receive a 75% tuition refund minus penalty for early withdrawal. No refund will be given for uniform costs. Hotel accommodation (on-campus only) refund is pro-rated based on the date of withdrawal. Second week withdrawal: Students, both FF I/II and Bridge, withdrawing during the second week of class will receive a 50% tuition refund minus penalty for early withdrawal. No refund will be given for uniform costs. Hotel accommodation (on-campus only) refund is pro-rated based on the date of withdrawal. Third week withdrawal: Tuition refunds will not be granted to FF I/II or Bridge students withdrawing during or after third week of class. No refund will be given for uniform costs. Hotel accommodation (on-campus only) refund is pro-rated based on the date of withdrawal. Registration Payment Policy Official registration requires full payment of the stated fees by credit card, personal check (for personal registration), or official purchase order (for government agencies or businesses) at the time of registration. Accepted credit cards are Discover, Mastercard, and Visa. Cancellation Policy The Alabama Fire College reserves the right to cancel or postpone any course that does not meet the minimum registration, is affected by inclement weather or for any situation requiring Alabama Fire College Staff. Courses that do not meet the minimum registration may be cancelled two (2) weeks prior to the start date. When a course is scheduled and advertised there is no guarantee that the course will be delivered. Courses cancelled due to inclement weather or other situations may be rescheduled. Drug Screening If at anytime a student appears to be under the influence of drugs or alcohol, the instructor may request to have drug screening performed at that time. The cost for this testing will be paid by either the sponsoring fire department or the student. A positive drug screen result will constitute dismissal from the program. For more information on policies and procedures, see the current Catalog.

6 Date Application Rec d Self-Sponsored / Department-Sponsored Name of Department ALABAMA FIRE COLLEGE 2501 Phoenix Drive Tuscaloosa, Alabama Recruit School Application Circle one: On-Campus (Tuscaloosa) / Regional Training Center: SSN: - - Begin date: End date: DOB: / / Sex: Race: (optional) Name: (Last) (Middle) (First) Home Address: City, State, Zip: County: Home Phone: Cell or Work Phone: * Address: *Student notifications, confirmations and cancellations will be sent via . Please make sure your address is correct and legible on the registration form. Felony Conviction Statement: I hereby affirm and certify, under penalty of perjury, that I have not been convicted of a felony and that I am not in violation of Alabama Administrative Code 360-X-1-.01(3)(d)5(e)1-2. I attest that all information provided herein is true and accurate to the best of my knowledge. Student Signature: By checking this box, I acknowledge I have read and understood the Felony Conviction Statement. Photo Release Statement: I hereby authorize the staff of the Alabama Fire College to use, reproduce, and/or publish photographs and/or video that may pertain to me, including my image, likeness and/or voice without compensation. I understand that this material may be used in various publications, public affairs releases, recruitment materials, broadcast public service advertising (PSAs) or for other related marketing endeavors. This material may also appear on the Alabama Fire College s website and other related social media sites. This authorization is continuous and may only be withdrawn by my specific revocation of this authorization in writing. If I do not wish to agree to this release statement, I will alert my instructor at the beginning of the class. By checking this box, I acknowledge I have read and understood the Photo Release Statement. THE FOLLOWING INFORMATION IS FOR OFFICE USE ONLY: Emergency Care Provider: Yes No PPE: Yes No Lodging: Yes No 4 nights 5 nights Total due: Payment date: Method of payment: All documentation complete date: File scanned to student record: Date: Initials: Registration notification date: Certification notification date:

7 TUITION & FEES Name: Course Location: Dates: Course options and tuition: Emer. Care Provider Tuition Only $100 Lodging Fee for Emer. Care Provider Lodging Fee for Emer. Care Provider Hotel accommodations for 2 nights a week (Wed. & Thurs. nights) (On-campus Recruit Schools only) Hotel accommodations for 3 nights a week (Tue. - Thurs. nights) (On-campus Recruit Schools only) $100 $150 Firefighter I/II Tuition Only $900 Lodging Fee for Firefighter I/II Lodging Fee for Firefighter I/II Hotel accommodations for nine weeks- 4 nights a week (Mon. - Thurs. nights) (On-campus Recruit Schools only) Hotel accommodations for nine weeks- 5 nights a week (Sun. -Thurs. nights) (On-campus Recruit Schools only) $1,080 $1,350 Bridge Program Tuition Only (5-week course for Certified Volunteer Firefighters who seek FF I/II certification for employment purposes) $600 Additional fees for self-sponsored students: PPE Rental Fee $700 (On-campus only. Non-refundable.) Out-of-state students: Additional Tuition: $1000 Total Due: $ Uniforms and textbook can be purchased from the AFC Bookstore on the AFC campus in Tuscaloosa, by phone at 1(866) , or online at Tuition and Fees are subject to change without notice.

8 METHOD OF PAYMENT Name: 1. Check Check #: Amount: 2. Money Order Money Order #: Amount: 3. Cash Amount: 4. Credit Card Visa Master Card Amount: Card Number: Expiration: Card Holder Name: Card Holder Signature: 5. Purchase Order PO #: Amount: Fire Department Address: Fire Department Phone Number: ATTENTION FIRE DEPARTMENT-SPONSORED STUDENTS: A fire department purchase order or a purchase order number must accompany your application packet when applying for admission to recruit school. The P.O. reserves a space for applicant in recruit school. The Alabama Fire College will invoice the sponsoring fire department for final payment.

9 Alabama Fire College and Personnel Standards Commission Note to applicant: Both pages of the following form must be completed and forwarded to the Alabama Fire College and Personnel Standards Commission within 30 DAYS after date of employment. *Recruit School requirements see note PHYSICAL STATEMENT The Physical and Medical examination should be conducted for the purpose of detecting or determining the presence of deficiencies or abnormalities which would reasonably be expected to limit the abilities of the applicant to satisfactorily and safely perform all the duties associated with firefighting. (Code of AL thru ; chapter 360-x-1 and as outlined in NFPA 1582). The Essential Functions of Firefighting listed below are meant to serve as a reference resource for physicians when determining the fitness of a candidate for firefighting duties. The Essential Functions of Firefighting are meant to define and to give a broader understanding of the physical requirements demanded of firefighters. The Essential Functions of Firefighting are merely meant to be used as an aid for physicians when determining the physical status of a candidate. Essential Functions of Firefighting, Based on NFPA 1582 Performing fire-fighting tasks (e.g., hoseline operations, extensive crawling, lifting and carrying heavy objects, ventilating roofs or walls using power or hand tools, forcible entry), rescue operations, and other emergency response actions under stressful conditions while wearing personal protective ensembles and self-contained breathing apparatus (SCBA), including working in extremely hot or cold environments for prolonged time periods Wearing a SCBA, which includes a demand valve type positive-pressure face piece or HEPA filter masks, which requires the ability to tolerate increased respiratory workloads Exposure to toxic fumes, irritants, particulates, biological (infectious) and nonbiological hazards, and/or heated gases, despite the use of personal protective ensembles and SCBA Depending on the local jurisdiction, climbing six or more flights of stairs while wearing fire protective ensemble weighing at least 50 lb (22.6 kg) or more and carrying equipment/tools weighing an additional 20 to 40 lb (9 to 18 kg) Wearing fire protective ensemble that is encapsulating and insulated, which will result in significant fluid loss that frequently progresses to clinical dehydration and can elevate core temperature to levels exceeding F (39 C) Searching, finding, and rescue-dragging or carrying victims ranging from newborns up to adults weighing over 200 lb (90 kg) to safety despite hazardous conditions and low visibility Advancing water-filled hoselines up to 2 1 / 2 in. (65 mm) in diameter from fire apparatus to occupancy [approximately 150 ft (50 m)], which can involve negotiating multiple flights of stairs, ladders, and other obstacles Climbing ladders, operating from heights, walking or crawling in the dark along narrow and uneven surfaces, and operating in proximity to electrical power lines and/or other hazards Unpredictable emergency requirements for prolonged periods of extreme physical exertion without benefit of warm-up, scheduled rest periods, meals, access to medication(s), or hydration Operating fire apparatus or other vehicles in an emergency mode with emergency lights and sirens page 1

10 Critical, time-sensitive, complex problem solving during physical exertion in stressful, hazardous environments, including hot, dark, tightly enclosed spaces, that is further aggravated by fatigue, flashing lights, sirens, and other distractions Ability to communicate (give and comprehend verbal orders) while wearing personal protective ensembles and SCBA under conditions of high background noise, poor visibility, and drenching from hoselines and/or fixed protection systems (sprinklers) Functioning as an integral component of a team, where sudden incapacitation of a member can result in mission failure or in risk of injury or death to civilians or other team members I have examined Applicant s Full Name Print and as a physician licensed to practice in the State of Alabama due hereby certify that the applicant is in good health and physically fit for the performance of the duties of a firefighter as outlined in NFPA Last 4 digits of Applicant s SSN: Physician s Signature Date of Examination Physician s Name Printed Name of Practice Address Office Number City State Zip *NOTE TO RECRUIT SCHOOL CHIEFS: Chiefs in charge of recruit schools must not allow the enrollment of any trainee who has not submitted to the AFC a successful completion of CPAT form, copy of trainee s Notice of Employment or Sponsorship Letter, and a Physical Statement. These forms are due at the AFC at least 72 hours prior to the first day of Recruit School. page 2

11 Medical Exam Form (to be completed by licensed physician, physician s assistant or nurse practitioner) Name: Height: Weight: lbs. Student is able to send verbal messages yes no Vision Status: Right Eye: 20/ Left Eye: 20/ Corrected: Blood Pressure: / Pulse Rate: Normal Abnormal If abnormal, explain 1. Skin 2. Head & Neck 3. Eyes 4. Ears, Nose, Throat 5. Teeth & Mouth 6. Lungs & Chest 7. Cardiovascular 8. Abdomen & Lymphatics 9. Genitalia/Hernia 10. Orthopedic Screening: a. Upper Extremities b. Lower Extremities c. Spine & Back 11. Neurological Tests and/or Vaccinations a. Tetanus/Booster Date: (Cannot be over 10 years old) b. Hepatitis: Shot Dates: Additional comments: Note: The student has provided me a copy of the essential functions for the program and he or she is able to perform these functions. This is to certify that on this day of,, I performed the above limited examination of and based upon the medical history given, and upon my evaluation, I am of the opinion that he/she IS IS NOT physically and medically able to participate in the Alabama Fire College program. Signature: Date: Phone #: Name: Address:

12 Alabama Fire College and Personnel Standards Commission This form must be submitted to the Alabama Fire College and Personnel Standards Commission within TEN DAYS after date of employment. *Recruit School requirements see note NOTICE OF EMPLOYMENT I, Fire Chief/Authorized Agent (Print) Position Fire Department City/District by means of this affidavit, hereby certify and warrant that the following represents a true and accurate statement of the qualifications for and terms of employment. I further certify that the individual listed below is an active employee of my organization and is covered by the same workers compensation insurance or other such protection as is extended to all other employees. Name of Employee Date of Birth Date of Employment Social Security Number Trainee (As defined in Code of Alabama ) Yes No If No, list Certification Number Signature Fire Chief/Authorized Agent Date Sworn to and subscribed before me this Day of, 20. Notary Public My Commission Expires A copy of physical statement from a licensed Alabama physician is required. (Form 05) *NOTE TO RECRUIT SCHOOL CHIEFS: Chiefs in charge of recruit schools must not allow the enrollment of any trainee who has not submitted to the AFC a successful completion of CPAT form, copy of trainee s Notice of Employment, and a Physical Statement. These forms are due at the AFC at least 72 hours prior to the first day of Recruit School. AFC & PSC Form 04 Rev. 4/21/10

13 Alabama Fire College Firefighter I/II Recruit School Circle one: On-Campus (Tuscaloosa) / Regional Training Center: UNIFORM SIZES FORM Please return this form to the bookstore. Name: Phone: Recruit School Dates: Location: Circle one: Self-Sponsored / Department-Sponsored For pricing information, call the Bookstore at 1(866) , or visit us online at Bookstore use only RECRUIT CLOTHES: SIZE: # Needed # Rec d 3 navy AFC RS t-shirts S M L XL 2XL 3 pairs of AFC navy running shorts (these run small) S M L XL 2XL 3 navy AFC golf shirts S M L XL 2XL 3 pairs of navy BDU pants (unhemmed length- student is responsible for hemming) Waist: (circle one) pair of navy sweatpants with white AFC logo S M L XL 2XL navy sweatshirt with white AFC logo S M L XL 2XL black, cotton belt AFC patch (for graduation uniform if needed) AFC badge (for graduation uniform if needed) GRADUATION UNIFORM: (On-Campus Recruit School only. For RTC students: The host department affiliated with the recruit school will provide the student with information regarding the graduation uniform at the beginning of the Recruit School.) long sleeve, gray dress shirt Neck: Sleeve: pair of dress pants, navy with red stripe Waist: Length: navy tie: (circle one) regular long Type: Amount: Number: Check Cash Money Order Purchase Order Department Name FD Address: FD Phone: Credit Card VISA MC DISCOVER Cardholder Name: Exp: Zip Code:

14 Information Verification I have read and understand the information presented in the Alabama Fire College Recruit School Program. Applicant Name (Print): Applicant Signature: Date: / / Currently, on-campus courses are eligible for VA benefits. Students must submit a certificate of eligibility from VA, a copy of his/her high school diploma, Change of Program or Place of Training Form (if applicable) and official transcripts from any and all schools previously attended. VA students are not charged any tuition if they no-show a class or withdraw the first day, thereafter the tuition is due in full. By signing below, I attest that I have full knowledge that all transcripts from all schools must be submitted. Applicant Signature: Date: / /

15 Mail or Fax Registration Packets to: Student Services Alabama Fire College 2501 Phoenix Drive Tuscaloosa, Alabama Fax: (205) Questions about recruit schools? Call 1(800) or To order books and gear, call the AFC Bookstore at 1(866)