Training Application

Sussex County Fire Academy
114 Morris Turnpike
973-948-7897
Newton NJ 07860
FAX 973-948-7898
Training/Facilities Application
Course Requested _______________________________ Department ________________________________
Address For Confirmation _____________________________________________________________________
(Zip)
Chief's Name _________________________________________ Daytime Phone ________________________
Dept. Training Officer's Name ___________________________ Daytime Phone ________________________
Dept. Safety Officer's Name _____________________________ Daytime Phone ________________________
Date Preferred - If more than one date is offered, please give an alternate choice
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PLEASE MAIL APPLICATION OR FAX TO FIRE ACADEMY AT (973) 948-7898
Enrollment Eligibility
Only those applicants meeting pre-requisites will be accepted.
Outdoor Programs (Practical Exercises)..........Turnout gear requirements will be given with confirmation.
Indoor Programs (Lectures).............................Be prepared to take notes and receive handouts.
Class Hours - Unless Otherwise Stated
Evening Classes – 7:30 PM - 10:30 PM
Saturday Classes – 8:30 AM - 4:30 PM
It is understood that any and all responsibility for personnel injury to any member(s) of the applying department shall rest
upon the municipality in which the member(s) of the applying department normally perform their duties, said department
members being active members assigned to the Fire Academy, Fire Training Center or satellite location. This responsibility
includes compliance with NJ PEOSHA regulations pertaining to firefighters.
Certification: I hereby certify that all personnel from this department enrolled in the above course are covered by workmen's
compensation and liability insurance or otherwise adequately insured.
Date________________________
________________________________________________________
Chief or Authorized Signature
Sussex County Fire Academy
114 Morris Turnpike
973-948-7897
Newton NJ 07860
FAX 973-948-7897
Members Enrolling for Training
Upon entering the premises of the Fire Academy for the purpose of training, the members listed below release the
Fire Academy of Sussex County and its instructors of any responsibility on their part, in case of accident:
Please Print Clearly Or Type
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