RHODE ISLAND DEPARTMENT OF PUBLIC SAFETY

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RHODE ISLAND DEPARTMENT OF PUBLIC SAFETY S t a t e F i r e M a r s h a l 1951 Smith St, North Providence RI 02911 Telephone: (401) 383-7717 Fax: (401) 415-8608 Colonel Steven G. O Donnell Commissioner, Department of Public Safety Superintendent, Rhode Island State Police John E. Chartier, CFI, EFO State Fire Marshal Division of the State Fire Marshal December 3, 2014 Dear Chief: Please review the enclosed application for the next Assistant Deputy State Fire Marshal class and NFPA certification program. The program is scheduled to begin on Monday, January 5, 2015. Classes will be held 3 days per week, Monday, Tuesday and Thursday each week, from 9:00 a.m. to 4:00 p.m. The class will last approximately March 19, 2015. Individuals to get first consideration will be those who are assigned the primary responsibility of enforcing the fire codes. If there are additional seats available, individuals that are either on a waiting list to enter Fire Prevention, or will eventually be assigned the responsibility of code enforcement, will be considered. Please check the appropriate box on the application. As in the past, the Chief of Department must sign all applications. Certification will not be issued without prior approval from each Chief of Department and the State Fire Marshal. NFPA Fire Inspector I certification has been incorporated into the Assistant Deputy program. NFPA charges a $300 fee for the certification exam (do not send checks to the Fire Academy). All information regarding the Fire Inspector I exam will be given on the first day of class. Note: The Fire Inspection and Code Enforcement (7 th Edition) IFSTA manual will be provided for use during the class but must be returned to the fire academy. It is highly recommended that each department purchase their own NFPA books for use during the program. After registering for the certification exam, code books may be purchased through NFPA for $90. The NFPA material includes NFPA 1 (2012), 13 (2010), 25 (2012), 72 (2010) and 101 (2012). The IFSTA manual must be purchased separately. Please review the enclosed application and BCI release form and make copies as needed. Please fax the completed application by December 19, 2014 to 401 415-8608 or send to 1951 Smith St. North Providence, RI 02911. Individuals accepted into the program will be contacted by this office. Any questions regarding this program, please contact Chief Deputy James Gumbley at (401) 383-7068. Sincerely, John Chartier, CFI, EFO State Fire Marshal Enclosures

Fire Inspector (ADSFM) Class Schedule January-March 2015 DAY DATE LOCATION TIME Monday Jan. 5, 2015 Roger Williams Park Zoo Providence, RI Tuesday Jan. 6, 2015 Roger Williams Park Zoo Providence, RI Thursday Jan. 8, 2015 Roger Williams Park Zoo Providence, RI Monday Jan. 12, 2015 Roger Williams Park Zoo Providence, RI Tuesday Jan. 13, 2015 Roger Williams Park Zoo Providence, RI Thursday Jan. 15, 2015 Roger Williams Park Zoo Providence, RI Tuesday Jan. 20, 2015 Roger Williams Park Zoo Providence, RI Thursday Jan. 22, 2015 Roger Williams Park Zoo Providence, RI Monday Jan. 26, 2015 Roger Williams Park Zoo Providence, RI Tuesday Jan. 27, 2015 Roger Williams Park Zoo Providence, RI Thursday Jan. 29, 2015 Roger Williams Park Zoo Providence, RI Monday Feb. 2, 2015 Roger Williams Park Zoo Providence, RI Tuesday Feb. 3, 2015 Roger Williams Park Zoo Providence, RI Thursday Feb. 5, 2015 Roger Williams Park Zoo Providence, RI Monday Feb. 9, 2015 Roger Williams Park Zoo Providence, RI Tuesday Feb. 10, 2015 Roger Williams Park Zoo Providence, RI Thursday Feb. 12, 2015 Roger Williams Park Zoo Providence, RI Monday Feb. 23, 2015 Roger Williams Park Zoo Providence, RI Tuesday Feb. 24, 2015 Roger Williams Park Zoo Providence, RI Thursday Feb. 26, 2015 Roger Williams Park Zoo Providence, RI

Monday March 2, 2015 New England Institute of Technology Tuesday March 3, 2015 New England Institute of Technology Thursday March 5, 2015 New England Institute of Technology Monday March 9, 2015 New England Institute of Technology Thursday March 12, 2015 Thursday March 19, 2015 New England Institute of Technology New England Institute of Technology

Division of State Fire Marshal 1951 Smith St. North Providence, RI 02911 Tel: (401) 383-7717 Fax: (401) 415-8608 BCI Form (Bureau of Criminal Identification) Social Security No.: TO WHOM IT MAY CONCERN: I,, D.O.B. Of (Complete Address - including zip code) have made application for the position of ASSISTANT DEPUTY STATE FIRE MARSHAL. By so doing I allow and permit the State Fire Marshal's Office to conduct a complete and proper background check, and I do hereby authorize John Chartier, Rhode Island State Fire Marshal, or his designee, to examine any and all police records that pertain to me. (Signature of Applicant) (Date) SUBSCRIBED AND SWORN TO BEFORE ME THIS DAY OF, 2009A.D. Notary Public (Commission Expires)

Division of State Fire Marshal 1951 Smith St. North Providence, RI 02911 Tel: (401) 383-7717 Fax: (401) 415-8608 STUDENT REGISTRATION FORM PERSONAL INFORMATION Name: Last 4 digits of Social Security No. Address: City: State: Zip Code: Daytime Telephone: Night Telephone: E-mail (REQUIRED): Department: PROGRAM INFORMATION Program Requested: Location: No application will be accepted without authorized signature and proof of prerequisite if needed. I certify that the information recorded on this application is correct. I agree to abide by the rules, policies, and regulations of the Rhode Island Fire Academy if I am admitted as a student. Falsification of information may result in denial of a course certificate. I hereby authorize release of any and all information concerning my enrollment in this course to the chief officer in charge or designee of my organization. All requests for information shall be in writing from said chief or designee. Signature of Applicant: Please check box if applicable Retired Non-Fire Service Personnel * If you are retired or non-fire service personnel, a fire academy liability waiver must be signed and attached. Chief or supervisor s signature (below) is not required. I certify that the listed applicant is a member of our fire department/agency and is covered by my organization s Worker s Compensation insurance while participating in such training, and that the Fire Education and Training Coordinating Board, its commissioners, officers, agents or employees shall not be liable for any injuries sustained during such training. This applicant is considered by my department s standards to be physically and emotionally fit to perform firefighting evolutions without special consideration. Chief or Supervisor Signature: