Zembower Fire Service Training Award Application Form

Nomination Form

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*
First Last
Your Title*
Your Email*
Department Information
Company / Department / Squad Name*
Company / Department / Squad County*
Mailing Address*
Street Address City State ZIP Code
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*
Comments
This field is for validation purposes and should be left unchanged.

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
Emergency Vehicle Driver In Service	12
Emergency Vehicle Operator Course	30
EMT I	540
EMT I to P Bridge	442
FD Safety Officer	30
Fire Command I	27
Fire Officer I	63
Fire Officer II	45
Fire Officer III	60
Fire Officer IV	60
Firefighter I	108
Firefighter II	60
Fireground Operations I	24
Fireground Operations II	24
First Responder Basic	45
First Responder Refresher	15
Hazardous Materials Operations	24
Hazardous Materials Technician	51
Incident Safety Officer	16
Instructor Training I	30
Instructor Training II	36
Leadership & Supervision	18
NIMS 100	3
NIMS 300	24
NIMS 400	16
NIMS 700	3
NIMS 800	3
Officer Continuing Education Classes	3
PALS	16
Paramedic Refresher	40
Protective Envelope & Foam	9
PTLS	16
Pumps	30
Rescue Specialist I	45
Rescue Tech Rope Rescue	50
Rescue Technician	66
Rescuer Refresher	27
Special Fires	24
Sprinkler & Standpipe	6
Strategy & Tactics	45
Swift Water Rescue Tech	30
Trench Rescue	30
Truck Company Operations	30
WMD	6

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

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 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

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Nomination Form

Training Year

Your Information

Department Information

Formula for Computing Points

MFRI Course Hours

Refresher Classes (Annually)

Maryland State Firemen's Association