4. Form Instructions:
   This form is to be used by authorized personnel of the fire, rescue and law enforcement communities only. This form is NOT to be used by members of the general public.
6. Responsible Party*
7. Email Address*
9. Phone Number *
10. Organization *
12. Name/Type of Class *
14. Facility to be Used:*
    -- Select One --Hagerstown Fire Department Training Center (HFDTC)- 940 Bowman AveAdministrative Office Classroom- 25 Church St
16. Date/Time *
    Date/Time Start Date

    Date/Time Start Time

    —

    Date/Time End Date

    Date/Time End Time
    Please be specific, include start and end time.
18. If requesting HFDTC, which facilities do you plan on utilizing? (Select all that apply)

    1. Classroom
    2. Burn Building
    3. Tower
    4. Vehicle/Dumpster Fire Props
    5. Drafting Pit
    6. Confined Space Prop
20. NOTE: ORGANIZATIONS UTILIZING HFDTC ARE REQUIRED TO SIGN A KEY OUT FROM THE ADMINISTRATIVE OFFICE, AND RETURN THE KEY AFTER EACH USE!
22. HFD Battalion Commander: 301-791-2544/301-800-9404
Leave This Blank:


24. 1. Receive an email copy of this form.
25. Email address

    This field is not part of the form submission.

26. Submit Submit and Print

* indicates a required field