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					                                         RIVERSIDE COUNTY FIRE DEPARTMENT
                                                          In cooperation with the
                                            California Department of Forestry and Fire Protection
                                   210 West San Jacinto Avenue  Perris, California 92570  (951) 940-6900  Fax (951) 940-6910




  John R. Hawkins
     Fire Chief


Proudly serving the                                        EMS CERTIFICATION FEE WAIVER
unincorporated
                                                      for RIVERSIDE COUNTY FIRE PERSONNEL
areas of Riverside
County and the
Cities of:

Banning               I attest that ________________________________________________ is employed with the
                                          (Printed Name of Employee/Applicant)
Beaumont
                     Riverside County Fire Department and has met the qualifications for payment of his/her
Calimesa
                      basic certification/accreditation/re-verification fees by Riverside County Fire / CAL FIRE
   
Canyon Lake           to the Riverside County Health Department EMS Agency.
   
Coachella
                          EMT I
Desert Hot Springs
                          EMT II
Indian Wells
                          EMD
Indio
   
Lake Elsinore              EMT P (initial) only for personnel assigned to the 1755-1757 classifications
   
La Quinta                  EMT P (re-verification) only for personnel assigned to the 1755-1757 classifications
   
Moreno Valley              Other    Specify__________
   
Palm Desert
   
Perris
   
Rancho Mirage
                     ____________________________________________ ___________________________
San Jacinto               Signature in BLUE ink (Captain or higher)                            Rank / Station #
   
Temecula

                      ____________________________________________ ________________________
                             Printed Name (Captain or higher)                         Date




                                 THIS FEE WAIVER CANNOT BE USED FOR THE PAYMENT OF LATE FEES

				
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posted:9/19/2011
language:English
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