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Office of the
Fire Marshal

Appendix F - Application for
Training Officer Certification

This information is gathered to correctly identify candidates for certification and to evaluate the certification program. Information is being collected solely for the purpose listed above in accordance with the Freedom of Information and Protection of Privacy Act.

Title (please print)
 
Last name
 
Given names
 
Address: (street number and name)                                                                                (apartment/unit number)                                                                                                                     
(city)                                                     (province)               (postal code)
 
Telephone Number
(include area code)
Fax Number
(include area code)
Employer (use the four/six digit local code)
Address: (street number and name)                                                                (apartment/unit number)
 
(City)                                                  (Province)                (Postal code)
 
Telephone Number
 (include area code)
Fax Number
(include area code)
If you are successful in obtaining certification, please indicate how you wish your name to appear on your certificate (please print)
 
Information for evaluation purposes
Age range:
checkbox18-29 years
checkbox30-49 years
checkbox50 or over
Sex
F / M
Years of service
checkboxFull-time Training Officer
checkbox Volunteer Training Officer
Education: state highest level completed in terms of years completed
checkboxElementary ________
checkboxSecondary _________
checkboxCommunity college_________
checkboxUniversity _________
Confirm completion of the following requirements for certification.   Check all appropriate boxes.

   Job Experience Requirement

   checkboxJob Experience Requirement Demonstration of Competences to Standards. (Sign-off sheet only)
   checkboxMinimum 2 years experience as a Training Officer (or Acting Training Officer)

   Academic Requirement

Regular Route

  (Employed as a training officer after May 30, 2005)
  checkbox Training Officer Diploma.
  Date received:_____/_______/______
                           (  MM /    DD    /   YR  )
  Enclose copy of OFC diploma  
  
 

Window of Opportunity

(Employed as a training officer before May 30, 2005)

    checkbox OFM Trainer/Facilitator Course
    checkbox CO 101 Legislation/Standards or equivalent
    checkbox CO 201 Leadership and Communication Theory or equivalent
    checkbox CO 202 Practical Communications and Supervision or equivalent
    checkbox OFC Applied Program Development course
    checkbox  Applied Program Delivery course or equivalents
I certify that the foregoing statements are true. I am aware that if any of the foregoing statements are willfully false, certification may be denied, revoked or suspended.



____________________________________________________________________
                                              Signature of Individual

 
   ______________________________________________
                                                Date

 
____________________________________________________________________
                                              Signature of Fire Chief
   ______________________________________________
                                                 Date
For Office Use Only
Date received
 
Certification  number
Documentation checked by secretary of Certification Office
Date Reviewed by Council Chairperson
Certification Awarded
FM CERT 01 (05/05)
Return completed form to: Chairperson, Certification Council, Academic Standards & Evaluation Section, Office of the Fire Marshal, 5775 Yonge Street, 7th Floor, North York, Ontario, M2M 4J1
The above is for reference only. Please use the PDF version for submitting the form.  Adobe Acrobat Reader software is freely available at www.adobe.com/acrobat/readstep.html