Host Department Application Package Fire Fighter Training ... · Fire Fighter Training Certificate...

Host Department Application Package Fire Fighter Training Certificate Programs

Academy Administration, 580 Fitzwilliam Street, Nanaimo, BC V9R 6E2 tel: (250) 755-4551 Updated June 22, 2016

Host Department Application Package

Fire Fighter Training Certificate Programs

Vancouver Island Emergency Response Academy (VIERA) would like to welcome career,

composite, volunteer departments, and other industrial brigades to the only Pro Board

accredited NFPA 1001 Level I and II Fire Fighter Training Certificate Programs in British

Columbia that offer a combination of on-line and face-to-face learning experiences to fit the

unique needs of your department and your members.

With access to a full curriculum of teaching and learning resources available through the on-

line learning management system, Moodle, departments will have the flexibility of providing

their own instruction, at their own pace with Academy-approved evaluations on-site or

arrange for instructors and evaluators on a contract basis. Departments will also have the

flexibility of choosing which combination of topics their firefighters will work on at one time.

This Host Department Application Package is your 5-step guide to enrolling your members

in a certificate program that is right for your department. When you have worked through this

guide and gathered the necessary documents, complete the Checklist and return the

information in your Application Package to VIERA:

Vancouver Island Emergency Response Academy 580 Fitzwilliam Street, Nanaimo, BC V9R 6E2 Tel: (250) 755-4551 Fax: (250) 753-5480 E-mail: [email protected] Website: www.vierafire.ca

mailto:[email protected]

http://www.vierafire.ca/



Table of Contents

Page

STEP 1 - Application ............................................................................................... 3

STEP 2 - Register for Courses ................................................................................ 3

STEP 3 - Obtain Course Materials .......................................................................... 4

STEP 4 - Instructors, Proctors and Evaluators ....................................................... 5

STEP 5 - Request Evaluations................................................................................ 6

Host Department CHECKLIST ............................................................................... 7



STEP 1 – APPLICATION

Apply for a program:

Choose a Certificate Program or Skills Maintenance Access

Complete the Department Information Form

Have each student complete an Application and Consent Form

Vancouver Island Emergency Response Academy (VIERA) offers three Fire Fighter Training

Certificate Programs to departments or industrial brigades to meet the corresponding NFPA

1001 - Standard for Fire Fighter Professional Qualifications, as well as Skills Maintenance

Access:

Fire Fighter Training Level I & II Certificate (levels are taught in combination)

13 courses + HazMat Awareness and HazMat Operations

Skills Maintenance Access

For members who are already certified but would like to maintain their skills with access to the online curriculum that supports the textbook resources.

If a student can provide evidence that they have successfully completed any of the courses

from another accredited institution, they will receive complete reciprocity.

Return completed Department Information Form and Application and Consent Forms in

your Application Package.

Submit additional Application and Consent Forms to enroll new members in the program

in the future. Forms may be faxed to the Academy Administration at (250) 753-5480.

STEP 2 – REGISTER FOR COURSES

The selection and order of courses will be at the discretion of the department, with the

exception of the Fire Suppression courses which require that students have met the

prerequisites in the NFPA 1403 standard 4.1.1 and 4.1.2.



Complete the Grouped Course Registration Form for your chosen certificate program

including:

a list of courses) requested at this time, or only Skills Maintenance Access;

the names of the members that will be participating in these courses;

payment for these courses:

o Cheque(s) or credit card information for each individual; OR

o Signed authorization for billing the department.

o Please note: once registration for a course has been completed, tuition fees

for the associated course are non-refundable

Return the Grouped Course Registration Form in your Application Package.

Submit additional Grouped Course Registration Forms to request further courses as your

members move through the program.

Forms may be faxed to the Academy Administration at (250) 753-5480.

STEP 3 – OBTAIN COURSE MATERIALS

Contact the Academy Administration to purchase required and optional resources.

Required Resources

Fundamentals of Fire Fighter Skills, Canadian 3rd edition

Additional Resources

Once your application is processed, your Department Contact Person for this program will

be emailed an information package to gain access to Moodle.

Moodle is an on-line learning management system that provides access to the on-line

course content, resources, learning tools and practice quizzes, and tracks evaluations.



Please note that only the designated contact person within your department will have

Administrative Access within the Moodle page. The Administrative Access will give this

person access to all the student grades within the Moodle grade book and the ability to alter

the Moodle page to fit the needs of your department.

The person who has Administrative Access must be the same “Department Contact” that is

identified by the students on the Application and Consent Form.

STEP 4 –PROCTORS, EVALUATORS and INSTRUCTORS

Departments may provide proctors and practical evaluators that are approved by VIERA,

and may provide their own instructors.

or

Departments may contact the Academy Administration at (250) 755-4551 to contract a

proctor, practical evaluator, or instructor for any of the courses in the certificate programs.

PROCTORS

Potential proctors must be provided with a copy of the Evaluator Manual found on the

VIERA website at www.vierafire.ca

They must review the section “Written Exam Evaluation Proctors” and all documents

referenced within that section and then sign the Operational Guideline Agreement

(form VIERA006).

Return the signed Operational Guideline Agreement in your Application Package

for review. The Department Contact will be notified of approval of proctors by email.

EVALUATORS

Any fire department individual wishing to evaluate candidates in the practical skills

for the NFPA 1001 program must attend a one day evaluator training program

conducted by VIERA. Please check the VIERA web page for evaluator training dates.

Note: an evaluator may not evaluate a candidate whom they have instructed to prepare

them for the course being evaluated.




Potential evaluators must be provided with a copy of the Evaluator Manual found on

the VIERA website at www.vierafire.ca

The potential evaluator must review the Evaluator Manual and all documents

referenced within that manual and then sign an Operational Guideline Agreement

(form VIERA006) and an Evaluator Agreement (form VIERA007).

Send the potential evaluator’s resume, a signed Operational Guideline Agreement

and signed Evaluator Agreement in your Application Package to be reviewed. If

they have completed an evaluator’s program at another accredited institution, please

provide proof of completion. The Department Contact will be notified of approval of

proctors by email

Please note that HazMat Operations must be evaluated by an experienced HazMat evaluator approved by VIERA and Fire Suppression courses (Live Fire) must be evaluated by an approved NFPA 1403 evaluator.

STEP 5 – REQUEST EVALUATIONS

When you are ready to request written and/or practical evaluations for the courses your

members are completing, submit the Evaluation Request Form. Students must be

registered in the courses in order to be evaluated.

Check the written and/or practical evaluations you are requesting.

Enter the number of students to be evaluated.

Enter the Preferred Evaluation Date.

Please note that requests for evaluations must be received by the Academy Administration

at least one month prior to the requested evaluation date. You will receive an email

confirming your request.

Pending any unforeseen circumstances, grades will be posted to student Moodle pages

within 30 days once evaluations and outstanding required information have been received

by VIERA.

Submit additional Evaluation Request Forms as your members move through the program. Forms may be faxed to the Academy Administration at (250) 753-5480.




CHECKLIST Host Department Application Package

Please use this checklist to ensure that you have completed the steps and included the required information in your Application Package.

STEP 1

complete Department Information Form

sign and complete Application and Consent Forms for each student

STEP 2

Complete Grouped Course Registration Form including:

courses requested at this time;

students to be enrolled;

payment information;

STEP 3

order required resources

Departments may include the following with their Application Package or submit them at a later date.

STEP 4

Operational Guideline Agreement signed by person applying to become a proctor of written evaluations

resume, Operational Guideline Agreement and Evaluator Agreement signed by person applying to become a practical evaluator

STEP 5

complete Evaluation Request Form for the first set of courses

Submit completed Application Package to:

Vancouver Island Emergency Response Academy 580 Fitzwilliam Street, Nanaimo, BC V9R 6E2

Department Information Form Fire Fighter Training Certificate Programs

Academy Administration, 580 Fitzwilliam Street, Nanaimo, BC V9R 6E2 tel: (250) 755-4551

Department Name: Phone:

Address:

Fax: DEPARTMENTAL CONTACT Please note – this contact will be the only person in the Department authorized to have administrative access to all student information and status within the program’s online page. Further this will be the individual with whom the certificate program’s administrative staff will connect for information, questions and concerns related to the certificate program as it relates to your department’s members.

Name: Position: Email: Phone: I declare that I will maintain confidentiality of all student information. In addition, I confirm that, as the “authority having jurisdiction”, my department maintains responsibility for the health and safety of all members participating in a certificate program.

˟

Department Contact Signature Date PROGRAM REQUESTED Check all the programs that your members will be using:

Fire Fighter Training Level I & II Certificate (NFPA 1001-30)

Fire Fighter Training Level I Certificate (NFPA 1001-10)

Fire Fighter Training Level II Certificate (NFPA 1001-20)


Application & Consent Form Fire Fighter Training Certificate Programs


Check One: (To be completed by student – Please print legibly)

Fire Fighter Training Level I & II Certificate (NFPA 1001-30) Fire Fighter Training Level I Certificate (NFPA 1001-10) Fire Fighter Training Level II Certificate (NFPA 1001-20) Skills Maintenance Access

Personal Information

First Name: Middle Name:

Last Name: Email:

Home Address: Phone #: Date of Birth:

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Consent to Release Information to Pro Board

I hereby consent to allowing Vancouver Island Emergency Response Academy to release the information on this form and course completion information to the National Board on Fire Service Professional Qualifications – Pro Board for the purpose of being registered with the Pro Board Certification Registry upon completion of the above program:

Last 4 digits only of your Social Insurance Number: (Last 4 digits only)

˟ Signature: Date: ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Consent to Release Information to Employer

I hereby consent to allowing Vancouver Island Emergency Response Academy to release to the Departmental Contact listed all personal information, test results, Certificate of Program Completion and verification of attendance in connection with this program.

Employer’s Name:

Employer Contact:

Employer's Address: (Street)

(City) (Province and Postal Code)

˟ Signature: Date:

It is the student’s responsibility to ensure Vancouver Island Emergency Response Academy is kept up-to-date on any changes to their contact info.

Grouped Course Registration Form - Fire Fighter Training Level 1 & 2


Department: _______________________________________ Department Contact: ________________________

GROUPED COURSES REQUESTED

Ch Course Selection Ch Course Selection

1 Orientation & History of the Fire Service, Fire Fighter Safety, Communications

8 Search and Rescue, Fire Fighter Survival

2 Personal Protective Equipment & Self-Contained Breathing Apparatus, Response and Size-up

9 FF Tools and Equipment, Forcible Entry

3 Water Supply, Fire Attack Lines and Foam

10 Salvage and Overhaul, Fire Cause Determination

4 Ladders, Ropes and Knots 11 Vehicle Rescue and Extrication, Assisting Special Rescue Teams

5 Fire Behaviour, Building Construction

6 Incident Management System

12 Pre-Incident Planning, Fire Prevention and Public Education

7 Ventilation, Fire Suppression, Wildland and Ground Fires

13 Fire Extinguishers, Fire Detection and Suppression Systems

PAYMENT INFORMATION (Check one)

Payments enclosed. Attach cheque/credit card information for each student.

Authorization to invoice Department

I hereby authorize VIERA to invoice the Department for tuition as indicated on this form, totalling $___________.

Authorized Signature:

Position:

Date:

STUDENTS TO BE REGISTERED

List the department members to be registered in these courses (use the back of the page if you need additional space).

Please ensure that all the students listed have submitted an Application and Consent Form.

Payment Calculation

Tuition Fees

Courses for Certification

$115 X ________ X ______ __= _______ # of students # of courses

Rewrite exams

$35 X ________ X ______ __= _______ # of students # of courses


$100 X ________ = _______ # of students Total Payment = _______

VIERA006 Page 1 2013-11-07

Vancouver Island Emergency Response Academy

Operational Guideline Agreement I, _____________________________, agree to review and adhere to all Operational

Guidelines as it pertains to my duties as an Instructor, Evaluator or Proctor at the Vancouver

Island Emergency Response Academy. I also agree to keep current with the Operational

Guidelines as they are revised or introduced.

INSTRUCTOR/ EVALUATOR/ PROCTOR: FIRE CHIEF: Print: Print: Sign: Sign: Date: Date:

VIERA007 Page 1 2013-11-07

Vancouver Island Emergency Response Academy

Evaluator Agreement I, , agree to the following Vancouver Island

Emergency Response Academy guidelines when conducting a practical evaluation.

Ensure that all students have received the requested evaluation checklist at least 24 hours prior to evaluation.

Provide clarification as needed regarding the checklist.

Ensure student’s name is clearly printed on the form.

Ensure all safety issues pertaining evaluation location are clearly identified to the student.

Clearly identify to the student all necessary equipment and PPE required.

Clearly state to the student that if any unsafe act occurs, or has potential to occur, the evaluation will be stopped and an unsuccessful will be issued to the student.

Provide no coaching once the evaluation begins. (This is a test of the student’s knowledge and skills.)

Clearly and concisely document practical deficiencies resulting in an unsuccessful student.

Instruct unsuccessful students to re-apply to Vancouver Island Emergency Response Academy (through proper channels) for a future evaluation date.

Sign and clearly print his/her name on all evaluations conducted. EVALUATOR: FIRE CHIEF: Print: Print: Sign: Sign: Date Date:

Evaluation Request Form Fire Fighter Training Level 1 & 2


Department: _______________________________________ Department Contact: ________________________

1. EVALUATIONS REQUESTED FOR THE FOLLOWING COURSE(S)

Evaluation Selection # of Students

Preferred Evaluation Date

Assisting Special Rescue Teams

Building Construction

Fire Attack Lines & Foam

Fire Behaviour

Fire Cause Determination

Fire Detection & Suppression Systems

Fire Fighter Safety

Fire Fighter Survival

Fire Fighter Tools and Equipment

Fire Prevention and Public Education

Fire Service Communications

Fire Suppression (Live Fire)

Forcible Entry

History / Orientation of the Fire Service

Incident Management System

Ladders

Personal Protective Equipment & Self-Contained Breathing Apparatus

Portable Fire Extinguishers

Preincident Planning

Response and Size-up

Ropes and Knots

Salvage and Overhaul

Search and Rescue

Vehicle Rescue and Extrication

Ventilation

Water Supply

Wildland and Ground Fires

HazMat Awareness

HazMat Operations

EXAM TRACKING (for office use only) Request Rec’d______________________ Course #1 _____________ Course #2 _______________ Course #3 _______________ Course #4 _____________

Date Sent: _____________ Date Sent: _______________ Date Sent: _______________ Date Sent: _____________

Date Ret’d: _____________ Date Ret’d: ______________ Date Ret’d: ______________ Date Ret’d: ____________

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