burke county fire and rescue college

Transcription

BURKE COUNTY
FIRE AND RESCUE
COLLEGE
DEDICATION
Randy L. McKinney
Randy started as a volunteer firefighter in 1976 with the Oak Hill Fire Department and served
for over 30 years. He is currently a volunteer firefighter in the West End Fire Department.
He was one of the first certified EMTs in Burke County and obtained the certification of
Paramedic in 1982. Randy was employed by Burke County EMS, where he was promoted to
the Director of EMS and Assistant Emergency Services Director. He retired in 2008. Currently,
he owns and operates a consulting training business for emergency services. Randy initiated
and was involved in a number of training programs designed to enhance the level of
pre-hospital care in Burke County. Randy is a fire service instructor, EMS instructor, adjunct
instructor for the National Fire Academy, and a FEMA instructor. He is also nationally certified
as a Type Ill Incident Commander, Planning Chief, and Operations Chief. In addition to his
formal education and training, he has served in numerous leadership roles. Randy is involved
in various aspects of training through community colleges across the state, both as a student
and as an instructor. We would like to thank Randy for his dedication and leadership
throughout the years.
DUAL (CONCURRENT) ENROLLMENT
This form is requ ired for current high school students 16-18 years of age. It must be
completed and returned with the Registration Form. Participants under 18 years of
age will be allowed to enroll in classroom activities only.
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ is currently enrolled, taking the equivalent
of one-half of a full-time schedule, and making progress toward graduation. Permission
is granted for he/she to enroll in
--------------------~atthe2014BurkeCountyFire
& Rescue College, to be held at Western Piedmont Community College's Foothills Higher
Education Center in Morganton, North Carolina. The student must be 16 years of age to
participate.
Principal/Counselor Signature
Date
HighSchool
Student Signature
Parent/Legal Guardian Signature
Approval of Director ofRecords & Registration (or designee)
21
The 2014 Burke County
Fire and Rescue College
Is made possible by the partnership
between
Western Piedmont Community College's
Emergency Services Training Center and
the Burke County Firefighters Association.
Burke County Firefighters Association
P.O. Box 219
Morganton, NC 28680
In Memory
Joseph W. Autrey
July 2, 1974—April 26, 2013
1
INVITED VENDORS
Anchor-Richey EVS
Atlantic Emergency Solutions
Brent's Customs
Blue Ridge Rescue Suppliers
Carolina Fire Rescue EMS Journal
Cornerstone Specialty Equipment
Fire Engine Collectables
Fisher's Sportswear
Harrison's Public Safety
L&A Emergency Equipment
Local Government Federal Credit Union
Medical Supply Solutions
MES
Mountain Tek
My Angel Tool
Newton's Fire & Safety Equipment
N.C. Forest Service
N.C. Society of Fire Rescue Instructors
Radio Communications Co.
Rhinehart Fire Services
Safe Industries
Stevens Fire Equipment
Tar Heel Emergency Sales
VFIS of N.C.
Wendy B's
911 Think Signs
2
TABLE OF CONTENTS
General Information/Directions/Motel Accommodations
Agenda
Courses:
PAGE
4
5
Building Construction- Sat/Sun
6
Emergency Medical Care
6
Fire Alarms & Communications
6
Fire Behavior
7
Fire Control
7
Fire Department Orientation & Safety
7
Fire Hose Streams and Appliances
8
Forcible Entry
8
HAZ MAT Levell Responder
9
Ladders
9
Overhaul
9
Portable Extinguishers
10
Rescue
10
Salvage
10
Ventilation
11
Water Supplies
11
EVD
12
Introduction to Pumps
12
TR General: Helicopter Transport
13
TR General Ropes
13
TR General: Rescue Operations
13
Emergency Incident Rehabilitation
14
Small Aircraft Crash (ARFF)
14
Understanding the NC Rating Response System
15
NIMS Incident Command System ICS-300
15
EMT Refresher
16
Chief101
17
Wildland Fire Red Card Training
17
Forms
Vendors
2
Verification of Training for Live Burn Exercises
18
Registration Form and Instructions
19-20
Dual (Current) Enrollment
21
3
Burke County Fire & Rescue College:
Foothills Higher Education Center
2128 South Sterling Street
Morganton, NC
All Burke County Fire & Rescue College
classes will be held at this location.
Practical exercises and other
demonstrations will be held at the new
Emergency Services Training Center and
will be determined during class times.
DIRECTIONS
From Interstate 40- Take exit 105. Turn right onto South Sterling Street. Travel through one
stoplight and the Foothills Higher Education Center will be on your left.
FIRE COLLEGE INFORMATION
COST:


$15.00 per person-All Emergency Personnel plus
$70.00 per person-(1-24 hour class) for
Non-Emergency Personnel or Out-of-State Participants
Substitutions will be accepted for students who are unable to attend.
Late registrations will be accepted if class size permits.
Students should indicate a 1st, 2nd, and 3rd choice of classes. Notification will be made to
students not registered for their 1st choice.
Minimum Age Requirement: Participants must be a minim urn of 16 years of age to enroll in
the Burke County Fire and Rescue College. Any participants ages 16 and 17 must have written
permission from his/her High School principal. The written permission must be submitted with
the registration form.
A dual enrollment form is included on page 21.

Participants under 18 years of age may only enroll in classroom activities.
Emergency Contact Information: In the event that a student needs to be reached for an
emergency while attending the College, calls should be directed to 828-448-6708.
 For other questions, contact Mike Willis at 828-448-6708.
MOTEL ACCOMMODATIONS
Make your reservations early!
The fall season brings many visitors to the foothills of the Blue Ridge Mountains. Be sure to
mention that you are attending the Burke County Fire and Rescue College.
Comfort Inns & Suites
Hwy 64 at 1-40, Exit 103
828-430-4000
Quality Inn
Hwy 18 S at 1-40, Exit 1OS
828-437-0171
Days Inn & Suites
Hwy 18 S at 1-40, Exit 103
828-430-8778
Sleep Inn
Hwy 18 S at 1-40, Exit 105
828-433-9000
Hampton Inn
Hwy 18 S at 1-40, Exit 1OS
828-432-2000
Economy Inn
Bethel Road at 1-40, Exit 106
828-437-7811
4
AGENDA
Foothills Higher Education Center
Thursday, October 16
8a.m.
HAZ MAT, Fire Control
and Wildland Red Card
begins.
Friday, October 17
8a.m.
1 p.m.
Vendor Set-Up
Classes begin based
on course description
Registration/ check-in
FHEC main lobby
5:30p.m.
Saturday, October 18
7:30a.m.
Ba.m.
Vendors Open
Registration and
check-in main lobby
Refreshments provided
8 a.m.
Classes begin based
12 p.m.
Lunch provided
1 p.m.
Classes begin based
Sunday, October 19
8 a.m.
Ba.m.
Vendors Open
Classes begin based
11:30 a.m.
Lunch on your own
12:30 p.m.
Classes begin based
Refreshments and lunch on Saturday provided by
Burke County Firefighters Association
5
FIREFIGHTER CERTIFICATION COURSES
BUILDING CONSTRUCTION
(FF II Certification)
15 Hours
This course will describe the basic structural characteristics of the different types of building
construction. The firefighter will be able to identify the general fire behavior expected with
each type of building construction, including the spread of fire and the safety of the building, occupants, and firefighters. Indicators of building collapses will also be covered.
Class Schedule:
Saturday
Sunday
8 a.m. -5 p.m.
8 a.m.- 4 p.m.
Instructor:
Brian Carswell
Hickory Fire Department
Certified Instructor
EMERGENCY MEDICAL CARE
(FF I Certification)
15 Hours
This course will provide the student with basic first aid skills including but not limited to:
hemorrhage control, burns, poisons, basic airway management and AHA CPR certification
for Healthcare Providers.
Class Schedule: Saturday
Sunday
8 a.m.-5 p.m.
8 a.m.-4 p.m.
Instructor:
STAFF
FIRE ALARMS & COMMUNICATIONS
(FF I & II Certification)
15 Hours
This course will prepare students to efficiently understand and effectively manage both telephone calls for assistance and the use of 2 way communication systems employed by the
fire service. Various types of alarm systems will be demonstrated to include the types of detectors utilized within those systems.
Sunday
8 a.m.-5 p.m.
8 a.m.-4 p.m.
Instructor:
6
Joey Belanger
Morganton Public Safety
FIRE BEHAVIOR
12 Hours
Fire behavior forms the basis of many operations on the fire scene. A basic understanding of
the chemical and physical nature of fire is required for safe and effective fire control.
Participants will become familiar with terminology; the fire triangle and tetrahedron; the
stages of fire and its conditions, signs, and indicators; and the transfer of heat.
Class Schedule:
Friday
6 p.m.-1 0 p.m.
Saturday 8 a.m.-5 p.m.
Instructor:
G. Winfield Abee
Western Region Fire/
Rescue Coordinator
FIRE CONTROL
33 Hours
*Full PPE including SCBA Required*
*Course begins at 8 a.m. on Thursday, October 16*
This course will cover both theory and practical application of methods used in controlling
vehicle fires, interior/exterior structure fires, ground cover fires and Class B fires. This is
physically demanding course and students should prepare accordingly.
Class Schedule:
Thursday 8 a.m.-5 p.m.
Friday
8 a.m.-6 p.m.
Instructor:
ESTC Staff
Sunday 8 a.m.-5 p.m.
NFPA 1403 Form required.
No one under 18 years of age permitted to take this class.
FIRE DEPARTMENT ORIENTATION & SAFETY
*Full PPE required*
21 Hours
Students will be exposed to the organizational structure and position roles of the fire and
rescue service. Services provided and laws and regulations governing department functions
will be covered. Various benefits and guidelines pertaining to departments and its members
will be discussed. Students will become aware of the alarming rate at which fire and rescue
personnel are injured or killed while performing duties. Case studies documenting incidents
will be utilized to emphasize that safety is a number one priority in emergency services.
Class Schedule:
Friday
Saturday
Sunday
6 p.m.-1 0 p.m.
8 a.m.-5:30p.m.
8 a.m.-5:30p.m.
7
Instructor:
T. J. Patton
Mooresville Fire Dept.
FIRE HOSE STREAMS AND APPLIANCES
*Full PPE is required*
21 Hours
This course will cover the use, care and maintenance of various types and styles of fire
service hose, appliances and nozzles as outlined in NFPA 1962. Students will demonstrate
proper hose lays for supply and attack operations and participate in proper nozzle selection
based on different fire scenarios. Proper fire stream production will also be demonstrated as
well as various types of hose loads and finishes.
Practical exercises on Sunday will be held off campus.
Class Schedule: Friday
6 p.m. -10 p.m.
Saturday 8 a.m.-5:30p.m.
Sunday 8 a.m. - 5:30 p.m.
Instructors:
Nick Reed Jr.
Tommy Oxentine
FORCIBLE ENTRY
*Full PPE Required*
14 Hours
Students participating in this course will be able to identify the different construction types
of doors and windows as well as various locks and lock assemblies. Students will learn the
proper techniques to force entry though these doors, windows, and locks using various
tools carried on typical fire apparatus. Care and maintenance of forcible entry tools will also
be covered. Practical exercise on Sunday will be held off campus.
Class Schedule:
Sunday
8 a.m.-4 p.m.
Instructor: Jon Lowdermilk
West End Fire Department
8
HAZ MAT LEVEL I RESPONDER
38 Hours
*Course begins at 8 a.m. on Thursday, October 16*
This course meets requirements for OSHA 1910.120 and NFPA 472 2008 edition. It is
designed to develop, through competence for those who will respond to a hazardous
material incident. It will also help to develop competencies to respond in a safe manner,
help reduce the number of accidents and injuries, and help prevent exposure to hazardous
material incidents. Students will use the DOT guidebook in a practical exercise. This will be a
fast-paced course and will require outside reading. The course will identify basic options,
requirements, and limitations of the methods used to control, contain or confine a
hazardous material incident. Practical exercise will be included.
Class Schedule:
Thursday
Friday
Saturday
Sunday
8 a.m.8 a.m.8 a.m.8 a.m.-
8 p.m.
8 p.m.
5 p.m.
5 p.m.
Instructor:
Mike Tinkham
Training Solutions, LLC
LADDERS
(FF I Certification}
*Full PPE Required*
14 Hours
Ground ladders are an essential part of fire ground operations. This course will provide
students with correct ladder identification, terminology, applications, carries, raises, care and
maintenance. Working individually and as a group, students will perform various carries,
raises and lowers. Students will also perform various hose applications and victim/firefighter
rescue techniques utilizing ground ladders.
Class Schedule:
Saturday 9 a.m.- 5 p.m.
Sunday 8 a.m.- 4 p.m.
Instructor:
Robin Triplett
OVERHAUL
(FF I & II Certification}
*Full PPE Required*
7 Hours
Students will become familiar with ways of establishing safe conditions for overhaul
practices, identifying the indicators of hidden fires, exposing hidden fires, and identifying
the procedures for extinguishing small burning objects and large furnishings. Securing a fire
scene and collecting and preserving evidence will be included. Practical exercises will be
held off campus.
Class Schedule: Sunday 8 a.m.- 4 p.m.
Instructor:
9
Ronnie Rector
PORTABLE EXTINGUISHERS
*Full PPE Required*
7 Hours
Proper use of extinguishers can enable personnel to put out a small fire before it becomes
life-threatening. Students will learn to identify the classes of fire and how to select the
proper extinguishers to use for each fire class. Inspection, maintenance, and hydrostatic
testing procedures will be explained. Practical exercises will be held off campus.
Class Schedule: Sunday 8 a.m.-4 p.m.
Instructor:
G. Winfield Abee
Western Region Fire/
Rescue Coordinator
RESCUE
*Full PPE Required*
24 Hours
*Course begins at 1 pm on Friday, October 17
Because of the dynamics of today's fire service, firefighters respond to all types of
emergencies. A firefighter's first priority is life safety. This course is designed to teach
firefighters methods of victim removal under various emergency conditions. Students will
utilize various tools and equipment for gaining access to victims, and perform proper carries
and drags for different injuries and situations. Students will also learn to assist with special
rescues such as MVA's, trench, elevator, and collapse rescue.
Class Schedule:
Friday
Saturday
Sunday
1 p.m.- 1 0 p.m.
8 a.m.-5 p.m.
8 a.m.-5 p.m.
Instructor:
Clay Greene
Lake James Fire Dept.
SALVAGE
{FF I Certification)
7 Hours
Firefighters will learn to minimize losses during and after fires by reducing fire, water, and
smoke damage through the use of good salvage procedures. Course content will include
various folds, rolls, deployment of salvage covers, and the construction and use of water
chutes and catchalls. Practical exercises will be held on campus.
Class Schedule: Saturday 9 a.m.-5 p.m.
Instructor: Ronnie Rector
10
11
Emergency Vehicle Driver
(D/0 Certification}
20 Hours
This course will present the knowledge, skills, and ability to satisfy the NFPA 1002 Fire
apparatus Driver/Operator Professional Qualifications 2009 Edition. Students must pass the
practical and written exam with a score of 70% or above to receive certification. Although
not required, participants are encouraged to bring apparatus they will be driving at their
respective agencies.
Students must be at least 18 years of age and have a valid NCDL to participate.
Class Schedule:
Friday
6 p.m. -1 Op.m.
Sunday
8 a.m.-4 p.m.
Instructor:
Claude Huffman, Retired
INTRODUCTION TO PUMPS
(D/0 Certification)
17 Hours
This class will introduce the student to the job or individual requirements for pump
operators and will detail the safe operation of the vehicle. Subjects will include: pump
anatomy, pump panel and engine gauges, relief valves, and basic pump set-up. Must be 18
or older to participate.
Class Schedule:
Friday
7 p.m.-10 p.m.
Saturday 9 a.m.- 5 p.m.
12
Instructor:
John Stroup
Salem Fire Department
TECHNICAL RESCUER CERTIFICATION
TR GENERAL: HELICOPTER TRANSPORT
(TR General Certification)
7 Hours
Helicopter evacuation requires a coordinated effort between ground and flight crews to
ensure the safety of everyone involved. Safety is the overall goal of any aero-medical
transport or rescue operation and can be achieved through teamwork and good
communication . Methods for establishing landing zones, types of patients that may need an
air medical ambulance, and safe practices around both air medical helicopters and the
Blackhawk helicopters used by the NC National Guard will be covered . An area medical
helicopter is scheduled to appear, weather and call volume permitting.
Class Schedule:
Sunday
8 a.m.-4 p.m.
Instructor:
Gary Ramsey
TR GENERAL: ROPES
20 hours
This course will present the Technical Rescuer safe and effective methods of rescue in elevated and below grade environments using ropes, knots and rope related equipment. Mechanical advantage, anchors, anchoring techniques and stress loads will be covered .
Saturday
Sunday
6 p.m. -10 p.m.
8 a.m. - 5 p.m.
8 a.m. - 5 p.m.
Instructors: Staff
TR GENERAL: RESCUE OPERATIONS
10 Hours
This course will identify the needed support resources, given a specific type of rescue
incident so that a resource cache is managed, scene lighting is provided for the tasks to be
undertaken, environmental concerns are managed, personnel rehabilitation is facilitated
and the support operation facilitates rescue operational objectives.
Class Schedule:
Friday
Saturday
7 p.m.-1 0 p.m.
9 a.m.-4 p.m.
Instructor: Gary Ramsey
13
SPECIALITY NON-CERTIFICATION
EMERGENCY INCIDENT REHABILITATION
12 Hours
Emergency Incident Rehabilitation is a result of mandate NFPA 1584. This course teaches the
responder to effectively perform responder rehabilitation on an emergency scene, and at
emergency training sites. This is a combination classroom and practical skills class. Participants will learn the reasons for the mandate, how to effectively start rehab program for their
departments, and will learn techniques for proper administration of the program. Responder
Rehab program is ideal for chief officers, safety officers, first responders, EMT's Paramedics
and SMAT members. An outdoor exercise is planned as part of the class.
Instructor: John Bruner, NREMT-P, SMAT Coordinator, Lieutenant, McDowell EMS
Equipment: Appropriate clothing for outdoor exercise
Class Schedule: Saturday 9 a.m.- 4 p.m.
Sunday 8 a.m. - 3 p.m.
SMALL AIRCRAFT CRASH RESCUE (ARFF)
14 Hours
This class is made up of classroom and hands-on training on the fire ground. The first day will
consist of lectures that will cover aircraft rescue and firefighting in a broad view along with a
focus on general aviation aircraft and the hazards of dealing with emergencies ofthis type of
aircraft. Day two will begin on the training ground where students will get an up close look
at a small general aviation aircraft. Students will learn proper approach procedures,
stabilization of the aircraft, securing the aircraft with a proper shutdown, and several
techniques for removal of victims from the cabin. There will be a live burn scenario where
students will apply what they have learned to control an aviation incident. This class will
utilize Cleveland Community College's new ARFF Training Aircraft. Students must meet
minimum age requirements (18 years of age or older).
NFPA 1403 guidelines will be followed, including facial hair guidelines.
Requires Chief signature on Chief's Verification Form.
Equipment: Full turnout gear required, SCBA and extra bottle. SCBA bottles must have
current hydro-test date.
Instructors: Cleveland Community College Staff
NCDOI and ARFF Certified Instructors
14
UNDERSTANDING THE NC RATING RESPONSE SYSTEM
12 Hours
This class will review all of the newest information and factors, which go into the make-up of
the Insurance Public Protection Classification for cities and rural fire districts. It is intended
for those persons interested in improving and /or maintaining the Fire Departments Public
Protection Classification, which possibly could result in lowering insurance premiums for
property owners. This class will cover the Communications, Fire Department, Water Information and Community Risk Reduction for a Graded area in the New Rating Requirements.
Sunday
9 a.m. - 4 p.m.
8 a.m. - 3 p.m.
Instructors: Terry Young
Davie Summey
NIMS INCIDENT COMMAND SYSTEM- ICS-300
18 Hours
This course provides greater description and details of the Incident Command System (ICS)
organization and operations, including application of essential principles and description of
air operations. There are five modules: Organization and Staffing, Organizing for Incidents
and Events, Resources Management, Air Operations and Incident, and Event Planning. This
course includes a final exam.
In order to receive credit for any NIMS classes students must have a TERMS
account and register for the class online. This is in addition to the BCFRC registration.
Prerequisite: ICS-1 00, ICS-200, ICS-700
Saturday
Sunday
6 p.m.-10 p.m.
9 a.m. - 5 p.m.
8 a.m. - 4 p.m.
Instructors: Randy McKinney, Retired
Burke County Emergency
Services Certified Instructor
15
EMT REFRESHER
24Hours
This EMT refresher course is open to EMT's of all levels currently credentialed in North
Carolina and/or by National Registry of EMT's.lt offers up to 24 hours of curriculum that
adheres to North Carolina and NREMT guidelines. This refresher course is divided into 2 & 3
hours blocks. Students may attend any combination of topics or all of the topics. For more
information, contact [email protected].
Instructors:
STAFF
EMT-REFRESHER SCHEDULE
Friday
8-11 a.m.
11 a.m. -12 Noon
1-3 p.m.
3-5 p.m.
Medical Emergencies (allergic reactions, drug overdose, water related
emergencies)
Airway (assessment & management)
Trauma Part 1 (trauma assessment, head & spine injuries)
Pediatrics Part 1 (respiratory & cardiac management)
Saturday
8-11 a.m.
11 a.m. -12 Noon
1-3 p.m.
3-5 p.m.
Trauma Part 2 (chest & abdominal injuries, shock management)
Pediatrics Part 2 (assessment)
Pediatrics Part 3 (trauma management)
Breathing (assessment & management)
Sunday
8-11 a.m.
11 a.m. -12 Noon
1 -3 p.m.
3-5p.m.
Cardiology Part 1 (cardiac compromise, cardiac arrest)
Pediatrics Part 4 (shock assessment & management)
Cardiology Part 2 (post resuscitation care)
Pediatrics Part 5 (delivery & post-delivery care)
16
CHIEF 101
12 Hours
This class consists of several programs that together will satisfy the 9s inspection criteria as
specified by the North Carolina Administrative code. The primary objective of the course is
to inform current and future chief officers of:

the various aspects and complexities surrounding the operations and organization of
North Carolina fire departments.
 understanding the basis of the procedures that govern a rating and response inspection.
 the various aspects of the response rating system as adopted in North Carolina.
 recognizing various sources of information that will assist departments in preparing for
an inspection.
Emphasis will be placed on ratings and inspections, NFIRS reporting, prevention and grant
programs, basic line-of-duty death information, financial considerations, and an overview of
the various expectations of being a chief officer.
Instructor: Kevin Gordon, Charlotte FD
Waco Community VFD
Wildland Firefighter Red Card Training
36 Hours
This course covers S-130, S-190 and L-180 NWCG Standards containing objectives of
entry level Firefighter skills to identify hazards, safety, fireline construction and fire control
measures. The course also covers wildland fire behavior and factors that affect fire
development.
Class Schedule: Thursday, Friday 8 a.m.-7 p.m.
Saturday, Sunday 8 a.m.-5 p.m.
17
Instructor: Chris Moss
Burke County Ranger
COMMUNITY
COLLEGE
VERIFICATION OF TRAINING
FOR
LIVE BURN EXERCISES
Tile firefighters listed below have received the minimum amount of training required by the
2012 edition ofNFPA 1403. As stated in NFPA 1403 Chapter 4 section 4.3.1, "Prior to being
pennitted to participate in live fire training evolutions, the student shall have received training
to meet the job perfom1ance requirements for Fire Fighter I in NFPA 1001, Standard for Fire
Fighter Professional Qualifications, related to the following subjects:"
(1)
(2)
(3)
(4)
(5)
Safety
Fire Behavior
Portable Extinguishers
Personal Protective Equipment
Ladders
(6)
(7)
(8)
(9)
(10)
(11)
Fire Hose, Appliances & Streams
Overhaul
Water Supply
Ventilation
Forcible Entry
Building Construction
An original Chiers Signature is required by each firefighter's name listed below.
Student Name(s)
Chiefs Signature
1.
2.
3.
4.
5.
6.
7.
8.
9.
10. ------------------------
Documentation of training will be made available to Western Piedmont Community College
upon request.
Fire Department
Fire Chief's Name
18
Date
IMPORTANT INFORMATION
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
Please send all registrations in by Monday, October 6, 2014.
Registration forms must be filled out completely and legibly (please print).
Please write out your agency name in the “Department affiliation” section.
Please write out your agency duties in the “Primary duties” section.
Example: Firefighter, Telecommunicator, Police Officer, Etc.
Circle either Paid or Volunteer.
Circle either State Agency or Local Agency.
Student and Chief signature must be on all registration forms.
Each participant 16 to 18 years of age and who are in high school must have a WPCC Concurrent
Enrollment form signed by his/her high school principal and sent in with the registration from.
Participants 16 to 18 years of age may not participate in Fire control or Small Aircraft Crash
Rescue courses.
Particpants enrolling Fire Control or Small Aircraft Crash Rescue must include “Verification of
Training Form” signed by the agency Chief with registration form.
Students cannot be officially enrolled in any course until all documentation and payment is
received.
Substitutions will be accepted for students who are unable to attend.
Late registrations will be accepted if class size permits.
Indicate 1st, 2nd and 3rd choices.
*****Western Piedmont Community College is a tobacco-free campus*****
FEES
• Burke County Fire and Rescue College fee is $15.00 per person (non-refundable) for all
participants.
• For Non-Emergency Personnel or Out-Of-State Participants, an additional registration fee of
$70.00 per person for classes that are 1-24 hours in length and $125.00 for classes that are 25-50
hours in length is required.
• Mail ALL necessary and completed forms along with payment to:
Western Piedmont Community College
Attn: Business Office/Fire College
1001 Burkemont Avenue
Morganton, NC 28655
• Make checks payable to: Western Piedmont Community College
• Western Piedmont community college’s policy regarding acceptance of checks:
1.
2.
3.
4.
All checks must include a physical street address.
Individual and company owned checks must include a driver license number.
All checks must include a phone number (work or home).
Counter checks, credit card checks, and computer-generated checks will not be accepted.
For registration and payment questions, contact Christine Brown at 828-448-6712 or [email protected]
For questions regarding courses and their content, contact Michael Willis at 828-448-6708 or [email protected]
Mail to: Western Piedmont Community College
Attn: Business Office/Fire College
1001 Burkemont Avenue
Morganton, NC 28655
WESTERN PIEDMONT
COMMUNITY COLLEGE
Name
Social Security #
Ethnic Origin (Check one):
Race (Please choose one):
Gender:
□
Female
□
□ Hispanic (HIS) □ Non-Hispanic/Latino (NHS) If this option was selected please complete the following Race section below:
□ American/Alaskan Native (AN) □ African American (BL) □ Asian (AS)
□ Caucasian (WH)
□ Hawaiian/Pacific Islander (HP)
Male
Information collected within this box is voluntary and for record keeping purposes only and will not be used in a discriminatory manner. This
information is required for federal and/or state reports, and for OSFM certifications. After registration, this information will be destroyed.
Please list your 1st, 2nd, & 3rd choice of classes. Please note that we will make all attempts to register you for the selected class
choices; however, if the class/es are full or cancelled, we will automatically register you for the next listed choice.
1st
2nd
3rd
Name:
(Last)
(First)
(Middle)
Mailing Address:
Email:
City:
State:
Zip:
County:
Home Telephone: ( ______) ____________________Work or Cell: ( ______) _______________Date of Birth: _________________
Highest Educational Level Completed:
Employment Status:
Citizenship:
Date last attended school (not a college):
□ Retired (R) □ Unemployed-Not Seeking Employment (UN) □ Unemployed-Seeking Employment (US)
□ Employed 1-10 hours/week (E1) □ Employed 11-20 hours/week (E2) □ Employed 21-39 hours/week (E3)
□ Employed 40+ hours/week (E4)
□ US Citizen (U) □ Eligible Legalized Resident Alien (E) □ Naturalized Citizen (N) □ Non-Resident Alien (A)
□ Undocumented Alien (D)
Please note that to be eligible for fee exemption, the course/s you are registering for must be directly related to job performance or
necessary to continue certification. If the information below is not populated in its entirety, there will not be a fee waiver and the student
will be responsible for payment. The student’s registration will be flagged to disallow further registrations until payment in full is made
or the required fee exemption information is received by Continuing Education Records.
WPCC reserves the right to ask for verification of fee exemption eligibility from the student and/or agency.
Department Affiliation (example: Fire, Rescue, EMS):
Clearly Print Department/Agency/Name (No Abbreviations)
Primary Duties Within Department:
□ Paid or □ Volunteer AND □ State Agency or □ Local/County Agency
Certification Courses
Student signature is required for this course as proof of registration and if the class is for certification, by affixing my signature, granting permission to release the appropriate course information to any appropriate certifying agency.
Student Signature
Date
Chief Signature
Date

burke county fire and rescue college

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