Rx Fire and Cultural Burn Trainings

Name *

First Name

Last Name

Phone *

(###)

###

####

Please select your gender identity. *

Nonbinary

Woman

Man

Prefer not to say

Are you a Lake County resident? *

Yes

No

Do you have any prior experience with prescribed fire or cultural burning? *

Yes

No

Are you Native American? *

Yes

No

Are you a client of Tribal TANF?

Yes

No

This question is for Native American participants only: Do you require a stipend?

Yes

No

Do you have reliable transportation to attend trainings? *

Yes

No

Would you like to register for the Cultural Fire Training taking place on Wed Sept 6? *

Yes

No

Would you like to register to take the Basic 32 Wildland Firefighter Type 2 (FFT2) 5-day course taking place Mon-Fri from Sept 25-29? *

Includes Work Capacity Test

Yes

No

Do you need to take the RT-130 Fireline Refresher course? *

Required annually to maintain FFT2 certification; only applicable if you have previously been FFT2 certified. Includes Field Day and pack test.

Yes, I need to recertify a previous FFT2 certification

No, I have never been FFT2 certified

No, my FFT2 cert is currently active

Would you like to register for the S-219 Firing Operations Training taking place on Tues-Wed Oct 3-4? *

Yes

No

Would you like to register for the Tactical Fire Training taking place on Tues-Wed Oct 17-18? *

Yes

No

I can provide the following as training resources during a training event.

Fire engine

ATV

UTV

Hand tools

PPE (please describe below)

Covid - 19 related PPE

Radio

Other (please describe below)

Emergency Contact Name *

First Name

Last Name

Emergency Contact Phone Number *

(###)

###

####

Do you agree to communicate with event organizers via email, to read and sign all required paperwork via DocuSign, and to provide your own leather workboots during your burn training? *

Yes, I agree

No, I have questions (someone from our team will contact you.)

Do you agree to be self-sufficient and to provide your own food and lodging for the duration of any training you attend? *

Yes, I agree.

No, I have questions (someone from our team will contact you)