Students who wish to have confirmation sent must include either a valid e-mail address or a self-addressed, stamped envelope with registration.
Registration Form  Tomahawk Fire & Rescue School 2008  

Name:___________________________________ Social Security No:______-____-______
Address:_________________________________ 
City: _________________________________ State :_____ Zip:_____________
Phone No.: (_____)____________ Dept/Squad/Industry Name:____________________________
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I am a legal resident of (circle one) City/Township/Village of: ________________________ County of:_________________ State of:_______
Circle highest grade completed:  9  10  11  12  13  14  15  16  17  18  19  20  21
Name of High School Attended:________________________________________________
City:______________________________________State:_____
Firefighter Certification No:____________________Chief Officer’s Signature:__________________

WORKER’S COMPENSATION Each participant must have Worker’s Compensation coverage by their respective department/squad/industry.  The Chief Officer of the Department or the industrial employers safety officer must sign this registration form.
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The following information is requested for state reporting purposes and to allow colleges to develop statistical profiles on the students served. Information provided will not affect admissions decisions and your cooperation is appreciated.
Do you identify with any particular ethnic group?:___________________________________Date of birth:_____________________ Male:_____ Female:_____
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Form instructions:
1) Browse the class offering listings and determine which class(es) you want to enroll in. Note the class number next to the class title.
2) Enter the corresponding class number below for each day you plan to attend.
3) In the event that the class you’ve chosen is already filled, you may designate alternate class selections as first, second, and third choices for each day.  

 Please note:  Some classes are subject to change. Check the website @ www.tomahawkfd.org for the latest updates/revisions.
Send this form with payment to:
Tomahawk Fire & Rescue School, PO Box 475, Tomahawk WI 54487