Student Feedback / Concern Form Thank you for being a student of this NH Fire Academy and EMS education program. As the Director of the Division, I am committed to each and every student having a positive experience, in a supportive environment with successful completion the program. To this end, I value ALL feedback from our program participants. This FEEDBACK/CONCERN FORM is a new mechanism that comes directly to me and is not viewed by any instructor. You may submit your feedback anonymously, or if you wish, add your name and contact information if you would like to discuss the matter further. I appreciate any feedback you have, positive or negative as we strive to offer the best training and education to our State’s emergency responders. Director Deborah PendergastNameIf you would like please submit your name and contact information. You are not required to submit any contact information but it would help to be able to get more information if needed. First Last Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email PhoneDate of incident* Month Day Year Instructor/Staff member involved* Description of incident* CAPTCHA