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Training Inquiry Form
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Name
*
First
Last
Layout
City
*
State
*
Department/Agency Name
*
What is your role within your department?
*
Chief Officer
Training Officer
Instructor
Firefighter/Rescue Technician
Junior Firefighter (Under 18 years old)
Other (Explain in Comments)
Contact Phone Number
*
Contact Email
*
Email
Confirm Email
Course Information Requested (Check all that apply)
*
Basic/Operations Level Vehicle Rescue
Advanced/Heavy Level Vehicle Rescue
New Vehicle Anatomy & Technology
Vehicle Rescue Refresher
Vehicle Winching, Lifting, & Moving
Farm Emergency Awareness
Farm Tractor/Machinery Extrication Training
Farm Silo Firefighting
Grain Bin Rescue Training
Emergency Medical Services-Specific Training
We would like to discuss customized training programs. Please specify topics in the Comments section below.
Other Vehicle or Farm/Ag Training Please specify the topics in the Comments section below.
Approximately how many students would be participating in the training?
*
Most RescueTechs programs are set-up for 20-25 students, although some of our awareness level programs can accommodate more students.
Additional Comments/Questions
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