2019 Haskell County Jon Hansen Series                        
Please complete this form in its entirety. (**) Pre-Requisite Required.  EVERYONE that registers must print the Pre-Requisite/Release Form, fill out, have signed and bring to class.  Incomplete registrations and not having form could hinder you being able to attend a class.  

Only Register one Firefighter at a time please.

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Email *
First Name *
Last Name *
Address *
Phone Number *
Fire Department *
2 Hrs - Saturday, November 9th
2 Hrs - Sunday, November 10th
8 Hrs - Friday & Saturday, November 8th & 9th
8 Hrs - Sunday, November 10th
12 Hrs - Friday & Saturday, November 8th & 9th
16 Hrs - Saturday & Sunday, November 9th & 10th
A copy of your responses will be emailed to the address you provided.
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