Academy Resource Request

Personal Demographics
Name*
First Middle Last
Do you work for the Department of Safety*
Your Division/Bureau*
Address*
Street Address City State ZIP Code
Your best contact phone number*
Your best contact Email*
Please select the resources that you would like to request*
- Classroom/Facility/Dorm Room
- Audio/Visual Equipment
- Vehicle Request
- Fire/EMS Course Prop Reservation

Facility Reservation
Start date that classroom or dormroom is needed*
MM slash DD slash YYYY
End date that classroom or dormroom is needed*
MM slash DD slash YYYY
Start time of event*

: Hours

Minutes

AM/PM
End time of event*

: Hours

Minutes

AM/PM
Are you requesting a CLASSROOM for an activity or a DORM room to stay in?*
- Classroom or auditorium
- Dormitory room
NO REQUESTS WILL BE APPROVED MORE THAN 60 DAYS PRIOR TO THE DATE OF THE ACTIVITY.
Requesting Organization*
Number of attendees*
Address of requesting organization*
Street Address City State ZIP Code
Contact person*
First Last
Position or title of contact person*
Activity description (how does this relate to the emergency medical or fire service, MUST be completed for consideration*

Dormitory Room Reservation
Emergency Contact Person*
First Last
Emergency contact person phone*
How many nights will you be staying?
Dormitory payment form
Copy and paste the URL link below into your web browser in order to download the dormitory payment form. Complete the form then attach it using the upload link below in order to send it with your online submission.
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Upload your payment page form here to send with your submission
Accepted file types: jpg, gif, png, pdf, doc, docx, Max. file size: 256 MB.
Total
$0.00

Audio Visual Request
Start Date
MM slash DD slash YYYY
End Date
MM slash DD slash YYYY
Time

:

AM/PM
I will need the following AV equipment:
- Computer and Projector in Classroom
- Conference Phone
- Portable Projector Screen
- Portable AV Kit for a Field Program
- Video Camera
- Digital Still Camera
It is recommended that you bring your presentation with you on a flash drive and use the provided podium computer. Your laptop or other device may not work properly with the academy system and you may not be able to display your presentation directly from your laptop depending on its age or style/type.
The conference phone will be delivered to the classroom and it is your responsibility to set the phone up and connect it to the network. The ED TECH group is not versed or responsible for conference phone connections.
You will be required to pick up the portable AV kit from the ED TECH office at the Fire Academy. A team member will open and review the kit contents with you to ensure that it is working properly. You will be responsible for the kit condition and its contents while it is in your possession. If something becomes broken you will be asked to place an out of service tag on the kit.
All persons who are requesting the use of our video cameras MUST be versed in their use. You will be responsible for filming your presentation or project as ED TECH personal are not included with the camera request to film. You will be responsible for the camera kit and its contents and condition while it is in your possession.
I will need access to the Academy's wireless network.
- YES
- NO
In order to access the wireless network you will need a one day access code pass and enter that information into the login screen when you open your internet browser on the day of your event. This pass can be obtained from the front reception desk when you arrive.

Fire Prop Reservation
Name of Requesting Agency or Department Affilication*
Name of training site
Training site address where class will be held
Street Address City State ZIP Code
Delivery Contact Information
Contact person for prop delivery
First Last
AFTER HOURS contact phone number

Date of first training session
MM slash DD slash YYYY
Start time

:

AM/PM
End time

:

AM/PM
Is there a 2nd training date and time?
- YES
- NO
Date of second training session
MM slash DD slash YYYY
Start time

:

AM/PM
End time

:

AM/PM
Is there a 3rd training date and time?
- YES
- NO
Date of third training session
MM slash DD slash YYYY
Start time

:

AM/PM
End time

:

AM/PM

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Step 1 of 9

Personal Demographics

Vehicle Request

Vehicle Information

Facility Reservation

Facility reservation continued

Select from the following

Dormitory Room Reservation

Audio Visual Request

Fire Prop Reservation

Delivery Contact Information

Props and Equipment

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