Application for Rescue 3 Training

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APPLICATION
FOR
RESCUE 3 TRAINING

 

Wimberley Fire Department
Attn: Rescue Training
P.O. Box 675
Wimberley, Tx 78676

For more information contact:
 

Lynn Burttschell or Carroll Czichos at (512) 847-3536 or by email: Training at Wimberleyfire.com        
 

***One-half of the tuition, as a deposit, is required to be mailed 14 days prior to class date***

 

Complete the following form or print it out and mail it with your check to:

 

Name:
 

Address:
 

City:
 

State:
 

Zip:
 

Department Name:
 

Phone Numbers:
 

Email:
 

Class Type:
 

Class Date:
 

Tuition:
 

New Student:
 

Recert:
 

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