Registrant Information:
First Name: Last Name:
E-Mail Address: Work Telephone: XXX-XXX-XXXX
IQCS Number: Select Classification:
Immediate Supervisor: Supervisor E-Mail:
Special Needs:
Gender:
T-shirt Size:
( The IQCS Number has 11 digits and is NOT a Social Security Number. Contact local FMO for IQCS number. If sponsored by federal agency, IQCS IS REQUIRED )


Billing Information (Please select the agency/unit/sub-unit of registration):
Agency:
If Agency Unavailable
(type here):
Unit:
If Unit Unavailable
(type here):
Sub-Unit:
If Sub-Unit Unavailable
(type here):
    Sponsoring Agency
(if applicable)
Billing Contact: Phone Number: XXX-XXX-XXXX
Billing E-Mail Address:



Week 1:

Select the course(s) you wish to attend:

Price
Choose Course(s) You Are Attending
Date(s)

Course Code

Course Name
Prework Required
Start Time

If Instructor Select all Courses You are Teaching

$160
5/11/15 - 5/15/15
Basic Fire Includes: ICS-100, L-180, S-130, S-190
No
8:00 A.M.
$135
5/11/15 - 5/14/15
Squad Boss Prep Includes: S-131, S-133, and S-134
Yes
8:00 A.M.
$60
5/11/15
Fire Fighter Type 1
No
8:00 P.M.
$85
5/12/15 - 5/13/15
LCES
Yes
8:00 A.M.
$60
5/14/15
Look Up, Look Down, Look Around
No
8:00 A.M.
$160
5/11/15 - 5/15/15
Intro to Wildland Fire Behavior Calculations
Yes
8:00 A.M.
$160
5/11/15 - 5/15/15
Single Resource Prep 1 Includes: I-200 and S-215
No
8:00 A.M.
$85
5/11/15 - 5/12/15
Baisc ICS
No
8:00 A.M.
$110
5/13/15 - 5/15/15
Fire Operations in Wildland / Urban Interface
No
8:00 A.M.
 
 
Week 2:

Select the course(s) you wish to attend:

Price
Choose Course(s) You Are Attending
Date(s)

Course Code

Course Name
Prework Required
Start Time

If Instructor Select all Courses You are Teaching

$160
5/18/15 - 5/22/15
Intermediate Wildland Fire Behavior
Yes
8:00 A.M.
$160
5/18/15 - 5/22/15
Introduction to Fire Effects
No
8:00 A.M.
$135
5/18/15 - 5/21/15
Single Resource Prep 2 Includes: L-280, S-219
Yes
8:00 P.M.
$85
5/18/15 - 5/19/15
Followership to Leadership
Yes
8:00 A.M.
$85
5/20/15 - 5/21/15
Ignition Operation
No
8:00 A.M.
$160
5/18/15 - 5/22/15
Strike Team Leader Prep Includes: I-300, S-330
Yes
8:00 A.M.
$85
5/18/15 - 5/19/15
Intermediate ICS for Expanding Incidents
No
8:00 A.M.
$110
5/20/15 - 5/22/15
Task Force / Strike Team Leader
Yes
8:00 A.M.
$110
5/19/15 - 5/21/15
Portable Pumps and Water Use
No
8:00 A.M.
$160
5/18/15 - 5/22/15
Facilitative Instructor
Yes
8:00 A.M.
$110
5/19/15 - 5/21/15
Heritage Resource
No
8:00 A.M.
 
 
LODGING:
Room Cost: $36.00 per night per person

Arrival Night Before Class Arrival Day Of Class No Lodging Requested

DINNER:
Dinner Cost: $14.50 per night per person

Arrival Night Before Class Arrival Day Of Class No Dinner Requested

PAYMENT DUE UPON REGISTRATION.