Chief or Training Officer: In this packet you will find eight (8) forms. The first four (4) forms need to be completed and returned to NIPSTA. The last four (4) forms contain information for you and your candidate. 1. Fire Department Attestation Form 2. Participant Acknowledgment and Release Of Claims Form 3. Candidate information Form 4. Emergency Information Form 5. OSFM Roster Notice 6. Candidate Equipment and Apparel Checklist 7. Required Textbook Notice 8. Physical Fitness Preparation and Expectation All departments must complete the first four (4) forms and return them to NIPSTA no later than one (1) week prior to the start of the program. These forms should be submitted to District Chief and Program Coordinator Orlando Diaz at
[email protected]. Please be advised that we maintain an “open campus” philosophy, which means that you and any member of your staff are invited to visit our training grounds at any time to see our operations first-hand. You will also receive weekly progress reports designed to help you track the progress of your personnel, and monitor day-to-day activities. Additionally, you be invited to a Chiefs Luncheon with your Candidate, which will be scheduled mid-way through the nine-week academy program. We thank you for the opportunity and privilege to train your personnel. Please do not hesitate to contact us if you have any Questions, or need more information. Sincerely, Ken Koerber Fire & Technical Rescue Program Director Northeastern Illinois Public Safety Training Academy Cell: 847-567-6976 Email:
[email protected] NIPSTA FIRE ACADEMY 2300 Patriot Boulevard Glenview Illinois ★ Phone: (847) 998-8090 ★ Fax: (847) 998-8091 Fire Department Attestation Form Candidate Name: Candidates Fire Department: Fire Academy Session Dates: The undersigned individual attests that the above named participant is enrolled in the NIPSTA Fire Academy on the dates listed above, and: .