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Skip Navigation LinksRegistration Form :: Forms :: Fire/Rescue Services :: Public Health & Safety :: Home

Fire/Rescue Services Registration Form


To ensure space is reserved for you or your department, please provide the following information: 

*Required Field

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Please provide full name including first, last and middle initial.

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First time registrants must provide a letter of affiliation on Agency letterhead to be fee-exempt.

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*Sex:

*Type of Course:

 
Are you taking this course to receive credit toward your certification or to satisfy your minimum training hours (will you be participating in the written/practical tests)?

 
Are you taking this course to receive credit toward your certification or to satisfy your minimum training hours (will you be participating in the written/practical tests)?

 
Are you taking this course to receive credit toward your certification or to satisfy your minimum training hours (will you be participating in the written/practical tests)?

 
Are you taking this course to receive credit toward your certification or to satisfy your minimum training hours (will you be participating in the written/practical tests)?

 
Are you taking this course to receive credit toward your certification or to satisfy your minimum training hours (will you be participating in the written/practical tests)?

 
Are you taking this course to receive credit toward your certification or to satisfy your minimum training hours (will you be participating in the written/practical tests)?

 
Are you taking this course to receive credit toward your certification or to satisfy your minimum training hours (will you be participating in the written/practical tests)?

 
Are you taking this course to receive credit toward your certification or to satisfy your minimum training hours (will you be participating in the written/practical tests)?

High school students must also complete the Joint Approval for Concurrent Enrollment form. This form must be filled out and signed by the high school principal and turned in at least a week prior to the start date of the class if the student is less than 18 years old (16 or 17).

Course dates/times are subject to change without notice. Updates to course dates/times will be posted on our website. In the event of a course cancellation, all registered students will be contacted. We do not confirm registrations at this time.

 

For more information, contact:
 

Jason Boggs
Fire Protection Technology Instructor
(919) 464-2360
jlboggs@johnstoncc.edu
Jeremey B. Daughtry
Director Fire/Rescue Services
(919) 464-2356
jbdaughtry1@johnstoncc.edu
 
Johnston Community College | 245 College Road | PO Box 2350 Smithfield, NC 27577
(919) 934-3051 - http://www.johnstoncc.edu - Copyright © 2014, All Rights Reserved.