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Get OH Grandfather Application 2007-2024

IFSAC Grandfather Application Ohio Fire Academy 8895 East Main Street Reynoldsburg Ohio 43068 Applicant Information Local 614-752-8818 Toll Free 888-726-7731 Fax 614-752-7111 Social Security Number Last four digits required Name Home Address City Home Website www. ohiofireacademy. com First MI Fax State Zip Last Date of Birth required Cell / Pager E-mail Address Current Fire Department / Organization Information Rank/Title/Position Fire Department/Organization Name Current Position Address Career Part Paid Volunteer Other Specify County FDID/Agency Category and Level of Certification Please Check the category/level of certification for which you are applying. Grandfather Certification 20 total Mark this block and all certifications below that you are applying for. Documentation must be submitted with the application illegible documentation will not be accepted. Only Certifications or Training received prior to December 31 2002 is eligible for the Grandfather Certification* Firefighter I Haz Mat Awareness Haz Mat Operations Instructor I Fire Inspector I Payment Method Each application must be accompanied by payment of appropriate certification fees. Only approved methods of payments are accepted* Check One Payment enclosed check or money order Payable to Treasurer State of Ohio Charge Credit Card Number Expiration Date Type of Card Bill my Department/organization PO A copy of the purchase order must be attached By my signature I am acknowledging the information provided is accurate and true. Applicant Signature Date PREVIOUS EDITIONS TO THIS FORM ARE OBSOLETE 12/18/2007 An equal opportunity employer and service provider Master Card Visa. ohiofireacademy. com First MI Fax State Zip Last Date of Birth required Cell / Pager E-mail Address Current Fire Department / Organization Information Rank/Title/Position Fire Department/Organization Name Current Position Address Career Part Paid Volunteer Other Specify County FDID/Agency Category and Level of Certification Please Check the category/level of certification for which you are applying. Grandfather Certification 20 total Mark this block and all certifications below that you are applying for. Grandfather Certification 20 total Mark this block and all certifications below that you are applying for. Documentation must be submitted with the application illegible documentation will not be accepted. Only Certifications or Training received prior to December 31 2002 is eligible for the Grandfather Certification* Firefighter I Haz Mat Awareness Haz Mat Operations Instructor I Fire Inspector I Payment Method Each application must be accompanied by payment of appropriate certification fees. Documentation must be submitted with the application illegible documentation will not be accepted. Only Certifications or Training received prior to December 31 2002 is eligible for the Grandfather Certification* Firefighter I Haz Mat Awareness Haz Mat Operations Instructor I Fire Inspector I Payment Method Each application must be accompanied by payment of appropriate certification fees. Only approved methods of payments are accepted* Check One Payment enclosed check or money order Payable to Treasurer State of Ohio Charge Credit Card Number Expiration Date Type of Card Bill my Department/organization PO A copy of the purchase order must be attached By my signature I am acknowledging the information provided is accurate and true. .

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