+----------------------+----------------------+----------------------+
| > **Request for      |                      |                      |
| > Prescribed Fire    |                      |                      |
| > Training           |                      |                      |
| > Assignment**       |                      |                      |
+======================+======================+======================+
| > **Applicant        |                      |                      |
| > Name:**            |                      |                      |
+----------------------+----------------------+----------------------+
| > **Applicant Duty   |                      |                      |
| > Station (e.g.,     |                      |                      |
| > FA-331, NIFC):**   |                      |                      |
| >                    |                      |                      |
+----------------------+----------------------+----------------------+
| > **Applicant E-mail |                      |                      |
| > Address:**         |                      |                      |
+----------------------+----------------------+----------------------+
| **Applicant Phone    | Work:                | Cell:                |
| Numbers:** Work:     |                      |                      |
+----------------------+----------------------+----------------------+
| **Supervisor Name:** |                      |                      |
|                      |                      |                      |
+----------------------+----------------------+----------------------+
| **Supervisor Phone   | Work:                | Cell:                |
| Numbers:**           |                      |                      |
+----------------------+----------------------+----------------------+
| **Date of supervisor |                      |                      |
| approval:**          |                      |                      |
+----------------------+----------------------+----------------------+
| **What is your       |                      |                      |
| trainee position?    |                      |                      |
| (Select only         |                      |                      |
| [one]{.underline}    |                      |                      |
| position per         |                      |                      |
| application.)**      |                      |                      |
+----------------------+----------------------+----------------------+
| > RXB1               | > FEMO               |                      |
+----------------------+----------------------+----------------------+
| > RXB2               | > FIRB               |                      |
+----------------------+----------------------+----------------------+
| > RXM1               | > FUMA               |                      |
+----------------------+----------------------+----------------------+
| > RXM2               | > PLDO               |                      |
+----------------------+----------------------+----------------------+
| > FIRL               | > Other:             |                      |
+----------------------+----------------------+----------------------+
| **What is your       |                      |                      |
| current function?**  |                      |                      |
+----------------------+----------------------+----------------------+
| > FMO                | > FOS                |                      |
+----------------------+----------------------+----------------------+
| > AFMO               | > Fuels Specialist   |                      |
+----------------------+----------------------+----------------------+
| > Engine Crew        | > Hotshot Crew       |                      |
+----------------------+----------------------+----------------------+
| > Fuels Crew         | > Helitack Crew      |                      |
+----------------------+----------------------+----------------------+
| > Smokejumper        | > Dispatch           |                      |
+----------------------+----------------------+----------------------+
| > Other Fire         |                      |                      |
| > Personnel          |                      |                      |
| > (Specify):         |                      |                      |
+----------------------+----------------------+----------------------+
| > Non-Fire Personnel |                      |                      |
| > (Specify):         |                      |                      |
+----------------------+----------------------+----------------------+
| **What is your       |                      |                      |
| reason for applying  |                      |                      |
| for the program?**   |                      |                      |
+----------------------+----------------------+----------------------+
| > 401 Incumbent      | > Gain new           |                      |
|                      | > qualifications     |                      |
+----------------------+----------------------+----------------------+
| > Maintain current   | > Other (Specify):   |                      |
| > qualifications     | >                    |                      |
+----------------------+----------------------+----------------------+
| **Where are you in   |                      |                      |
| the Position Task    |                      |                      |
| Book (PTB)           |                      |                      |
| process?**           |                      |                      |
+----------------------+----------------------+----------------------+
| > Initiated PTB      | > 70%                | > 100% - need        |
|                      |                      | > additional         |
|                      |                      | > assignment         |
+----------------------+----------------------+----------------------+
| > 50% or less        | > 80%                |                      |
+----------------------+----------------------+----------------------+
| > 60%                | > 90% +              |                      |
+----------------------+----------------------+----------------------+
| **Dates of           |                      |                      |
| availability (Be     |                      |                      |
| reasonable and stay  |                      |                      |
| within the fiscal    |                      |                      |
| year---October       |                      |                      |
| through              |                      |                      |
| September):**        |                      |                      |
+----------------------+----------------------+----------------------+
| > Start Date:        | > End Date:          |                      |
+----------------------+----------------------+----------------------+
| > Start Date:        | > End Date:          |                      |
+----------------------+----------------------+----------------------+
| **Additional         |                      |                      |
| information          |                      |                      |
| regarding the        |                      |                      |
| assignment (e.g.,    |                      |                      |
| type of fuel,        |                      |                      |
| complexity of        |                      |                      |
| assignment needed):\ |                      |                      |
| **                   |                      |                      |
+----------------------+----------------------+----------------------+

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