SOP_NUMBER: 511.07-att-1
TITLE: Georgia Fire Academy - Student Authorization Form
REFERENCE_CODE: IVN04-0005
DIVISION: Facilities
TOPIC_AREA: 511 Policy-Fire Services
EFFECTIVE_DATE: 2001-08-15
WORD_COUNT: 432
POWERDMS_URL: https://public.powerdms.com/GADOC/documents/105854
URL: https://gps.press/sop-data/511.07-att-1/

SUMMARY:
This form is required for all students enrolling in Georgia Fire Academy courses. It documents student eligibility, agency affiliation, and authorizes participation in fire service training. Students must be at least 18 years old, represent an eligible fire department or organization, and their agency must hold a valid Certificate of Compliance. The form serves as written acknowledgment that the State of Georgia and Georgia Fire Academy are held harmless for any injuries or medical expenses incurred during training.

KEY_TOPICS: Georgia Fire Academy, student authorization, fire academy enrollment, student registration, fire service training, eligibility requirements, Certificate of Compliance, fire department training, Georgia Public Safety Training Center, student form, fire academy prerequisites, training authorization, firefighter certification

ATTACHMENTS:
  1. Georgia Fire Academy - Student Authorization Form
     URL: https://gps.press/sop-data/511.07-att-1/

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FULL TEXT:
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```
                                        GDC-SOP IVN04-0005
                                            ATTACHMENT 1
                                          REVISED 8/15/01

           Georgia Fire Academy - Student Authorization Form
.REQUIRED FOR ALL COURSES      RETURN TO: GEORGIA FIRE ACADEMY
.All information must be printed and       Georgia Public Safety Training
Center
filled out completely.      1000 Indian Springs Drive
.Form must be received by GFA at         Forsyth, Ga. 31029
least two weeks prior to first day
of course.
_______________________________________________________________________________
Course Code      |Course Title       | Agency ID/Compliance Number
```

______________________|________________________|_______________________________
**Course Dates     |Course Location     |   Type of Agency/Department**
______________________|________________________|_______________________________
**Agency/Department** | **Telephone     |1.  Government**
____________________________|_(       )_____________________________| **A.  Municipal**
**Address           |Alternate Phone  |   B.  County**
____________________________|_(        )_____________________________| **C.  State**
**City                        |State                  Zip                   |   D.  Federal**
|                       | **2. Independent Corporation**
**|** **|3. Private Corporation**
____________________________|__________________|_______________________________
**County       |  Cong. Dist.   |**
___________________|______________________________|Dept. Located      miles from GPSTC
The Georgia Fire Academy will provide instruction in the course and no responsibility other than to offer the opportunity to learn under supervision.
To register as a student in Georgia Fire Academy classes, the following are required:

1. **Must be at least 18 years of age.**
2. Must be an active member and representative of a Department or Organization eligible to receive Fire Academy   training. Georgia Fire Department must have
complied with Code Section 25 Laws and hold a valid Certificate   of Compliance.
3. Have no known physical and/or other conditions that would eliminate participating in the course, class, or   school.
4. Assure that payment for any and all medical or first aid treatment charges will be the responsibility of   the Department or Organization represented.
5. Must have a completed Student Authorization/Pre-Registration Form on file indicating Department approval   for student to participate in class.
6. If a Georgia firefighter, applicant must have completed a Basic Firefighter Course by or through GFA or an   approved or an approved equivalent.

**UNDERSTANDING:**
It is understood that the students listed are eligible to receive fire service training, expect nothing more than the opportunity to learn under supervision in a controlled
atmosphere and, therefore, hold harmless the State of Georgia, the Board of Public Safety, the Georgia Fire Academy, or any agent thereof for services rendered.

The students listed are members of this agency/department and are eligible to receive training as requested by this form. Fire Chief or Chief of Training must sign and
date this form; form will be rejected without proper signature and Certificate of Compliance Number.

Signed:______________________________________Title:_______________Date:_______     (Chief or Training Officer/Dept. Head)
Students listed indicates that he or she certifies that the information on this form is true and that he or she has read, understands, and agrees to the provisions listed.

Please Type or Print        *Resident Programs Only










|S.S. Number|Students Name|Rank/Title|Date of Birth|Sex*<br>(M-F)|Date Joined<br>Org.|Lodging*<br>(Y-N)|Signature|
|---|---|---|---|---|---|---|---|
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