SDFA State Fire School - Class/Presentation Submission Form

First Name *

Primary Contact - First Name

Last Name *

Primary Contact - Last Name

Organization

Primary Contact - Name of Organization Affiliated with (if applicable)

Title

Primary Contact - Title (if applicable)

Email *

Primary Contact - email address

Phone *

Primary Contact - Phone # (enter best number to contact you)

Address Line 1 *

Primary Contact - Address Line 1

Address Line 2

Primary Contact - Address Line 2

City *

Primary Contact - City

State *

Primary Contact - State

Enter required value

Postal Code *

Primary Contact - Zip Code

Comments

Use this field to enter any additional Primary Contact information you deem relevant.

How long have you been a Fire Service Instructor *

Please indicate roughly how long your have been instructing for the Fire Service.

Have you instructed at other State or Regional Fire Training Events *

What other National, State or Regional Fire Schools have you been an instructor for?

If you have instructed at other State or Regional Fire Schools please let us know where and when in the following text box.  In the case of multiple instructors please summarize.

Instructor Bio. *

Please use the following text box to provide a brief instructor bio.  In the case of multiple instructors please summarize.  NOTE:  We often provide instructor bios. on our registration page with the class descriptions, brief bios. seem to be best, if they are too long the are often un-read.

Title of Class/Presentation *

Please provide the title/name of the proposed Class/Presentation

Description of Class/Presentation *

Please provide a description of the class/presentation you are proposing.  NOTE:  Class descriptions are listed on our website and registration page for attendees to view to help them choose their class selection and are generally one of the items most considered by our attendees when choosing a class.  Please include learning objectives.

Type of class/presentation *

Please indicate if you class will be primarily

Classroom/Lecture Learning

Hands-On-Training (generally with some classroom component)

Enter required value Classroom Only Hands-On-Training

What length of Class/Presentation is being propsed. *

We generally offer three different total class lengths as follows:

3-4 Hour Session (half day AM & PM) - These are typically offered four times over the course of the event, each day both AM and PM (4 total classes).

6-8 Hour Session (full day) - These are typically offered twice over the course of the event, one class each day.

14-16 Hour Session - This will be a full 2 days class offering only 1 session during the event.

Enter required value Half Day Full Day 2 Day

Class Size Limit

Most classroom only classes at our event are limited to around 26-28 students primarily due to the size of the classrooms available, we do have some theater type seating available for larger classes if needed.  Many of the Hands-On-Classes we offer the instructor(s) wish to limit participation to keep student/instructor ratios reasonable, and in some cases classroom only sessions are also limited to encourage student participation.  If your class would have a size limit for number of students per session, please enter it below.

Number of Instructors *

Please list the number of instructors you plan to use to present the class/presentation

Are there any class supplies, apparatus, equipment, props, etc... needed.

Please list any supplies, apparatus, equipment, props, etc... that the SDFA Board will need to provide for the class, items the instructor will not be providing.  NOTE:  All classrooms in use would have computer and projector, those items do not need to be listed.

Estimated TOTAL Travel Costs

Please list TOTAL estimated travel costs, in the case of multiple instructors please list TOTAL estimated for all instructors.

Estimated TOTAL instructor fees/honorarium

Please list the estimated total cost of instructor fees/honorariums.  In the case of a class with multiple instructors please list TOTAL estimated cost for all.

Estimated TOTAL Meals/Per-Diem Costs

If applicable and not included in Instructor(s) Fees/Honorarium please least TOTAL estimated cost for Meals/Per-Diem.  We typically provide a noon meal to all students and instructors on Friday and Saturday as part of the event.

Estimated TOTAL Cost of Supplies, Props, Etc...

Please list the TOTAL estimated cost of any needed Supplies, Props, Etc.... (NOTE:  Do NOT include supplies and props that the SDFA Board will be providing)

Estimated TOTAL Cost of Incidentals/Misc. Items

Please provide estimated TOTAL cost of any Incidentals/Misc. items not previously accounted for.

Class Costs Text

Please enter any relevant information related to costs related to your proposal that should be considered or further information to explain the above listed costs.

Student Pre-Requisites

Are there any pre-requisites, pre-course work or other requirements for students registering for this class.  Keep in mind the SDFA has a limited ability to enforce educational or experience pre-requisites, other than listing them in the class description.  Please list any requirements in the text box below.

Student PPE Requirements

Are there any PPE requirements for students participating in the class?  These items will be listed with the class description, please be specific so students arrive with any and all PPE Needed.  Items to consider

• Wildland PPE
• Rescue Extrication PPE
• Full Structural PPE
• SCBA w/spare Cylinder
• Work Boots
• Work Gloves
• Eye Protection
• Hearing Protection

Please use the text box below to list any specific PPE requirements.

Miscellanious Information

Please use the text box below to list any relevant information not mentioned above.