Zembower Fire Service Training Award Application Form

"*" indicates required fields

Training Year

July 1 - June 30

Start Year*

Enter starting year (July 1, _____) and the ending year will auto-calculate.

End Year*

Your Information

Your Name*

Your Title*

Your Email*

Department Information

Company / Department / Squad Name*

Company / Department / Squad County*

Mailing Address*

Formula for Computing Points

List all courses and seminars sponsored by MFRI, formal courses sponsored by local training academies which are members of the Maryland Council of Fire and Rescue Academies, courses and seminars sponsored by MIEMSS, and courses sponsored by the National Fire Academy, for which your department has participated in during the training year noted above, in attached file.

Enter all information as requested and be as accurate as possible to ensure eligibility. All fire and rescue departments in the State are eligible for consideration for this award.

In columns: student's full name, location / host company, ending date, class title, course hours, total student hours.

File*

Accepted file types: docx, doc, xlsx, xls, pdf, txt, Max. file size: 10 MB.

1. Multiply number of hours for each course or seminar by the number of students successfully completing that course or seminar to determine the number of student hours for that course or seminar. The training information will be based on information provided by the sponsoring organization.

2. Total the student hours for all courses and seminars.

Number of Active Members*

From MSFA Statistical Report.

3. Divide the total number of student hours (in #2 above) by the number of active members in the department from current Statistical Report.

4. The result is your training hours per active member.

Average Training Hours Per Active Member*

Phone

This field is for validation purposes and should be left unchanged.

Award Information

MFRI Course Hours

*These hours should be similar for courses sponsored by local academies.

Class	Hours
ACLS	8
Aerial Apparatus Operator (Combined TCO&AAO)	24
Aerial Apparatus Operators	30
Arson Investigation for Officers	6
Boat Operations	8
Confined Space Rescue	30
Emergency Medical Services Officer I	48
Emergency Medical Services Officer II	42
Emergency Medical Technician - Basic	131
Emergency Medical Technician - Re-fresher	24

Refresher Classes (ANNUALLY)

Class	Hours
Bloodborne / Airborne Pathogens	1.5
Confined Space Rescue	1.5
CPR / AED	1.5
Hazardous Materials	1.5
SCBA	1.5
Trench Rescue	1.5

Courses and Classes Information

One day seminars are considered 6 hours and two day seminars are considered 12 hours. Seminars may include:

Executive Development Seminars
Chief Officers Seminar
Hazardous Materials Training
Confined Space
Rescue Weekends
Water Supply Drills, etc.

CPR training and other classes offered in the station must be documented with the number of hours of all students.

Documentation could include AHA or ARC pocket cards or a signed letter from a certified instructor.

All courses will be reviewed by the MSFA Training Committee for verification and acceptance of the appropriateness of the training for award consideration.

The following list of National Fire Academy courses is not an exhaustive list, but are those that are routinely offered and are 12 hours each:

Firefighter Health & Safety
Firefighter Safety & Survival
Incident Command System
IRHMIBC
IRHMICI
MCTO: Decision Making
MCTO: Preparation
MCTO: Tactics
Incident Safety Officer
Health & Safety Officer
Conducting Basic Fire
Prevention Inspections
Basic Life Support-Hazardous Materials

Maryland State

FIREFIGHTERS ASSOCIATION