Source: https://www.frederickcountymd.gov/FormCenter/Fire--Rescue-6/DFRS-TRAINING-REQUEST-FORM-58
Timestamp: 2019-11-22 09:44:30
Document Index: 415422654

Matched Legal Cases: ['art: 01', 'art: 01', 'art: 02', 'art: 05', 'art: 03', 'art: 04', 'art: 04']

DFRS TRAINING REQUEST FORM
Required for all DFRS personnel
State Provider ID#*
SSN (Last 5 Digits)*
-- Select One --MDPAWVVA
Station/Shift*
EMT Expiration Date
Course Information - DFRS Academy
ICS 300, MGMT-263-A014-2020 Academy, Start: 01-02-2020, End: 01-16-2020
ICS 400, MGMT-264-A012-2020, Start: 01-23-2020, End: 01-30-2020
Conducting Safe Live Fire Training Evolutions, MGMT-215-A010-2020, Start: 02-17-2020, End: 02-24-2020
Fire Department Health and Safety Officer, MGMT-216-A011-2020, Start: 05-08-2020, End: 07-02-2020
Fire Officer II, MGMT-202-A019-2020, Start: 03-05-2020, End: 04-23-2020
Pumping Apparatus Driver/Operator, FIRE-113-A033-2020, Start: 04-47-2020, End: 06-01-2020
RT - Swiftwater RT, RES-213-A012-2020, Start: 04-01-2020, End: 06-03-2020
Course Information - MFRI North Central & Western MD Regions
-- Select One --FIRE-114-S004-2020; Howard County DFRS Training Academy; Start Date: 09-14-2019; End Date: 09-29-2019; Days: Sa/Su; Time: 08:00FIRE-114-S006-2020; Westminster Fire Engine & Hose Company No. 1; Start Date: 10-09-2019; End Date: 11-06-2019; Days: M/W; Time: 19:00FIRE-114-S005-2020; Howard County DFRS Training Academy; Start Date: 10-16-2019; End Date: 10-31-2019; Days: M-F; Time: 08:00FIRE-114-S007-2020; Frederick County Training Center; Start Date: 10-24-2019; End Date: 11-16-2019; Days: Tu/Th/Sa; Time: 19:00
-- Select One --MGMT-215-A001-2020; Howard County DFRS Training Academy; Start Date: 09-28-2019; End Date: 09-29-2019; Days: Sa/Su; Time: 08:00MGMT-215-S002-2020; Howard County DFRS Training Academy; Start Date: 11-12-2019; End Date: 11-15-2019; Days: Tu/F; Time: 08:00
-- Select One --FIRE-137-S001-2020; Howard County DFRS Training Academy; Start Date: 10-09-2019; End Date: 10-18-2019; Days: Tu/W/F; Time: 08:00
-- Select One --N/A
-- Select One --FIRE-207-S004-2020; Winfield Community Volunteer Fire Department; Start Date: 10-24-2019; End Date: 11-19-2019; Days: Tu/Th; Time: 19:00FIRE-207-S003-2020; West Friendship Volunteer Fire Department; Start Date: 11-11-2019; End Date: 12-02-2019; Days: M/W/Sa; Time: 19:00
Fire Department Equal Opportunity Officer I
Fire Department Health Safety Officer
-- Select One --MGMT-216-S002-2020; Howard County DFRS Training Academy; Start Date: 09-16-2019; End Date: 10-16-2019; Days: M-F; Time: 08:00
-- Select One --MGMT-217-S004-2020; Howard County DFRS Training Academy; Start Date: 09-02-2019; End Date: 09-17-2019; Days: M/Tu/W/Th; Time: 08:00
-- Select One --MGMT-201-S008-2020; Howard County DFRS Training Academy; Start Date: 08-12-2019; End Date: 09-23-2019; Days: M-F; Time: 08:00MGMT-201-S009-2020; Carroll County Public Safety Training Center; Start Date: 08-27-2019; End Date: 11-05-2019; Days: Tu/Th; Time: 19:00MGMT-201-S007-2020; Howard County DFRS Training Academy; Start Date: 10-17-2019; End Date: 12-17-2019; Days: Tu/Th/Sa; Time: 19:
-- Select One --MGMT-202-S006-2020; Howard County DFRS Training Academy; Start Date: 10-02-2019; End Date: 11-01-2019; Day(s): M-F; Time: 08:00MGMT-202-S007-2020; Frederick County Training Center; Start Date: 10-24-2019; End Date: 12-19-2019; Day(s): Tu/Th; Time: 19:00
Firefighter Survival & Rescue
-- Select One --FIRE-206-S029-2020; Frederick County Training Center; Start Date: 12-03-2019; End Date: 12-08-2019; Day(s): Tu/Th/Sa/Su; Time: 19:00
ICS-300, Intermediate ICS for Expanding Incidents for Operational First Responders - NFA
-- Select One --MGMT-263-S004-2020; Howard County DFRS Training Academy; Start Date: 11-20-2019; End Date: 11-29-2019; Day(s): Tu/W/F; Time: 08:00
ICS-400, Advanced ICS for Command and General Staff, Complex Incidents and MACS for Operational First Responders - NFA
-- Select One --MGMT-264-S004-2020; Howard County DFRS Training Academy; Start Date: 12-04-2019; End Date: 12-13-2019; Day(s): Tu/W/F; Time: 08:00
-- Select One --MGMT-110-S005-2020; Howard County DFRS Training Academy; Start Date: 07-17-2019; End Date: 08-07-2019; Day(s): M-F; Time: 08:00MGMT-110-S004-2020; Howard County DFRS Training Academy; Start Date: 09-05-2019; End Date: 10-10-2019; Day(s): Tu/Th; Time: 19:00MGMT-110-S006-2020; Frederick County Training Center; Start Date: 09-12-2019; End Date: 10-22-2019; Day(s): Tu/Th; Time: 19:00MGMT-110-S007-2020; Carroll County Public Safety Training Center; Start Date: 11-06-2019; End Date: 12-18-2019; Day(s): M/W; Time: 19:00
-- Select One --MGMT-210-S002-2020; Howard County DFRS Training Academy; Start Date: 09-04-2019; End Date: 10-07-2019; Day(s): M-F; Time: 08:00MGMT-210-S003-2020; Frederick County Training Center; Start Date: 10-29-2019; End Date: 12-12-2019; Day(s): Tu/Th; Time: 19:00
-- Select One --MGMT-241-S002-2020; Graceham Volunteer Fire Company, Inc.; Start Date: 08-17-2019; End Date: 08-18-2019; Day(s): Sa/Su; Time: 08:00MGMT-241-S001-2020; Howard County DFRS Training Academy; Start Date: 09-16-2019; End Date: 09-19-2019; Day(s): M/Th; Time: 08:00
-- Select One --MGMT-243-S001-2020; Howard County DFRS Training Academy; Start Date: 09-23-2019; End Date: 09-26-2019; Day(s): M/Th; Time: 08:00
Leadership in Supervision: Perspectives in Thinking (NFA)
-- Select One --MGMT-242-S001-2020; Howard County DFRS Training Academy; Start Date: 09-30-2019; End Date: 10-03-2019; Day(s): M/Th; Time: 08:00
New Fire Chief I: Challenging Issues - NFA
New Fire Chief II: Administrative Issues - NFA
-- Select One --FIRE-133-S001-2020; Howard County DFRS Training Academy; Start Date: 09-24-2019; End Date: 09-30-2019; Day(s): M/Tu/F; Time: 08:00
-- Select One --FIRE-113-S011-2020; Winfield Community Volunteer Fire Department; Start Date: 09-19-2019; End Date: 10-22-2019; Day(s): Tu/Th; Time: 19:00FIRE-113-S010-2020; Howard County DFRS Training Academy; Start Date: 09-24-2019; End Date: 10-15-2019; Day(s): M-F; Time: 08:00FIRE-113-S009-2020; Howard County DFRS Training Academy; Start Date: 10-03-2019; End Date: 11-05-2019; Day(s): Tu/Th/Sa; Time: 19:00
Rescue Technician - Confined Space Rescue
-- Select One --RES-101-S010-2020; Reese & Community Volunteer Fire Company, Inc.; Start Date: 09-09-2019; End Date: 09-30-2019; Day(s): M/W; Time: 19:00RES-101-S008-2020; Howard County DFRS Training Academy; Start Date: 10-08-2019; End Date: 10-31-2019; Day(s): Tu/Th/Sa; Time: 19:00RES-101-S011-2020; Guardian Hose Company Activities Building; Start Date: 10-28-2019; End Date: 11-11-2019; Day(s): M/W; Time: 19:00
-- Select One --FIRE-124-S001-2020; Howard County DFRS Training Academy; Start Date: 09-09-2019; End Date: 09-18-2019; Day(s): M/W/Th; Time: 08:00
PLEASE ATTACH INFORMATION (BROCHURE, NOTICE, ETC.) ABOUT THE COURSE.
REFER TO DFRS POLICY 2.01.11 FOR REGISTRATION INFORMATION.
Cost of Class/Course
County Vehicle Request?
Estimate Vehicle Mileage
(Estimate mileage) x (Current rate) = Travel Cost
If applicable, in addition to your Battalion Chief, also select Battalion Chief Mike Cole and Captain Kathleen Harne for ALS Training. For Special Ops, also select David Barnes. IF REQUESTING A VEHICLE OR IF THERE IS A FEE ASSOCIATED WITH THIS TRAINING, ALSO SELECT THE BATTALION CHIEF OF TRAINING.
Coe, Tom
Dmuchowski, Mike
Grossnickle, Troy
Hahn, Rusty
Stolberg, Lenne
Wallick, Doug
Captains & Lieutenants will receive immediate notification of training request.
Ahalt, Bill
Baer, Richie
Bailey, Andre'
Bare, Craig
Bennett, Donnie
Carmack, Newman
Cave, Chad
Chlebowski, Josef
Coe, Jordan
Dimopoulos, Christopher
Dishart, Joshua
Goforth, Kevin
Hardin, Daniel
Harne, Jacob
Harne, Kathleen
Harner, Tyler
Hubble, Keith
Hubler, David
Johnikin, Anne
Komykoski, Jason
Laird, Josh
McKittrick, Jesse
McTighe Jr., Patrick
Morlan, Christopher
Mullendore, Chris
William Rossomondo
Schwab, Warren
Stansbury, Matthew
Stitely, Richard
Strausbaugh, Kyle
Wachter, Vernon
Welsh, Larrie
Wiles, Matthew
I agree to submit to DFRS documentation regarding my successful completion of this course. I further agree to abide by the Travel Regulations and Expense Report procedures detailed in Section IV of the Frederick County Purchasing Rules & Regulations, if applicable.*
Checking box is equivalent to my electronic signature.
Approved As:*