2018 - 2019 Firefighter I & II Application

Our Mission


To Educate...Facilitate...Motivate


and prepare our students to proudly serve the community and continuously uphold our


"Commitment to Excellence"

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The Application Process


PLEASE READ THIS CAREFULLY


You are completing the online application for the Coral Springs Regional Institute of Public Safety's Firefighter I & II program. Upon successful completion of this 450 hour program you will receive a Certificate of Completion and be eligible to take the state of Florida performance objective skills test and the written competency exam to obtain your Florida Firefighter Certificate of Compliance.

This application is 3 pages and the student is required to complete all three.
Page 1: Firefighter I & II Application (this page).
Page 2: Select the class start date.
Page 3: Application payment.

All students are required to complete this application along with satisfying the registration payment in order to apply.

Please be advised that you are entering into a binding contract with the Coral Springs Regional Institute of Public Safety.

Applications will not be reviewed without a paid application fee. If the application fee is not paid, your application will be set to incomplete and you will risk the class being sold out.

The email you identify in this application will be used as the primary means of communication, including informing you of your application status. Check your email regularly!

All applications are pending until they have been reviewed for accuracy and the student is notified of acceptance. Do not call the office to check on your status. All students will be notified during the Notification Period on the Academic Calendar.




Thank you for choosing the Coral Springs Regional Institute of Public Safety as your educational provider.


Did You Do Your Due Diligence?


Deciding to enroll at the Coral Springs Regional Institute of Public Safety to pursue your dream of becoming a Firefighter/EMT/Paramedic in the State of Florida is a huge step. This is a para-military organization that will require you to excel on every level in order to achieve success. It takes a tremendous amount of dedication and sacrifice to achieve your career goals. On our website, we have taken measures to assist you in choosing the right class that makes the most sense for you. Please be sure you review it carefully in order to understand what will be expected of you.

The Program Catalog and Student Reference Guide is available to you 24 hours a day, 7 days a week on the CSRIPS website when you hover on the About Us tab. It is up to you, the student, to review the catalog and understand the refund policy, the code of conduct and rules and regulations you will be held to. There will be an open book exam on this catalog upon acceptance of the program. The intent is not fail the student but to ensure the student is aware of the rules and knows where to find them.

Student Information


If you are a returning student, please enter the primary email you have on record. A different email will cause a duplicate record to be created and may delay or deny your application in being processed.

Please be sure to enter your legal name (no nicknames).

Your middle name is required by the State. Please enter your full middle name, not just the initial. If you DO NOT have a legal middle name, please enter None.


Click here for instructions on how to obtain an FCDICE number.

Emergency Contact Information


In the event of an emergency, who should we notify?

Parent/Guardian Information


If you are under the age of 18, you must complete this section.


Pre-requisites


Because not all pre-requisites are due at the time of application (some are due after application but prior to the start of class), this list is not all inclusive. Please visit the Firefighter I & II course description for complete details.

Students must successfully complete the Entrance PAT at the Coral Springs Regional Institute of Public Safety. If you do not have a valid Entrance PAT, your application will not be accepted.

Students who are accepted into the Firefighter I & II program will receive instructions welcoming them to CSRIPS and the required course pre-work.


Must be signed and box 1 or box 2 signed also

Must be signed


EMS Requirements


Students must have one of the certificates or licenses below in order to apply for Firefighter I & II. If the student does not have any of these, the student will not be accepted.


You can upload your NREMT cert if you are waiting on your state cert)


Veterans Affairs


If you plan to utilize your GI benefits, you are required to complete this section. If you have attended another school and have used your VA benefits, you must upload a copy of your transcript. If you have not used your benefits, you must upload a copy of your Joint Service Transcript.

Individual Education Plan (IEP)


It is the responsibility of the Chief Training Officer to ensure the Coral Springs Regional Institute of Public Safety is in compliance with the Americans with Disabilities Act. The ADA provides civil rights protection for persons with disabilities. These rights are parallel to those rights that have been established by the federal government for women and minorities. A qualified individual with a disability cannot be denied admittance to participation in or benefit from goods services, facilities, programs, privileges, advantages, or accommodations at the Coral Springs Regional Institute of Public Safety.

If a student enrolls in CSRIPS and he/she has a disability, it is the responsibility of the student to indicate they possess an IEP on this application. Only Transition IEP's from a school district are accepted. IEP's must be declared at the time of application and there is no guarantee that accommodations can be granted. A review with the Chief of Training and Accreditation Coordinator will be conducted prior to acceptance into the program. No IEP's will accepted after registration closes.

For further information regarding a student with an IEP, please refer to the Americans with Disabilities Act section of the Program Catalog and Student Reference Guide on the csrips.org website.

Please keep in mind there are Special Requirements outlined in the Program Catalog and Student Reference Guide for the Firefighter I & II program. Although not specifically tested for prior to admission, these requirements are directly related to the job of a Firefighter. Further job requirements and restrictions can be found at on the website of the Division of State Fire Marshal.

Student Enrollment Agreement


Students will be provided the Student Enrollment Agreement (SEA) through their MyCSRIPS student portal once they are accepted. The SEA must be accepted in order for the student to complete the registration process. This document will reiterate the Refund Policy, withdrawal procedures, transfers of credit, and communications which are all part of the Program Catalog and Student Reference Guide.



If the SEA is not accepted, your application will not be considered complete and you will not be enrolled.

Florida Prepaid


Please indicate if you will be using Florida Prepaid benefits.

Release and Waiver


FOR CORAL SPRINGS REGIONAL INSTITUTE OF PUBLIC SAFETY TRAINING, TESTING, AND/OR EDUCATION


In consideration for my acceptance to a training, testing, and/or educational program at the City of Coral Springs, I agree to sign this Release and Waiver. Accordingly, I agree to unconditionally release, waive, and discharge the City of Coral Springs, its Commission members, employees, agents, and servants, all hereafter referred to as “releases,” from all claims and causes of action, that I, my personal representatives, assigns, heirs, and next of kin, may have for any loss, damage, or injury to person or property, whether caused by the negligence, or otherwise of the releases in connection with my participation in any training, testing, and/or educational program at the City of Coral Springs. In addition, I agree to indemnify completely, the releases against all claims, demands, made by or on behalf of me in relation to my participation in any training, testing, and/or educational program and all causes of actions arising out of my own actions or involvement with the City of Coral Springs.

The physical requirements for the training, testing, and/or education program that I want to participate in have been explained to me and I certify and warrant that I am in good health and physical condition and able to participate in all activities that may be required. I also understand that I may come into contact with hazards, including but not limited to, blood borne pathogens, fire, and hazardous chemicals that may cause great bodily injury or death. I fully realize and appreciate the foregoing risks and freely and voluntarily accept those risks. Additionally, I agree to adhere to the applicable rules and regulations of the City of Coral Springs.

In addition, I authorize the City of Coral Springs or its agent to conduct a required criminal background check. I understand and authorize the City of Coral Springs to disclose this information to any and all clinical sites I may be involved with during my education at the City of Coral Springs. I understand and agree that I may be denied entry into the program, or removed from the program, due to an unacceptable criminal background, as determined by the City of Coral Springs, in their sole discretion.

I HAVE CAREFULLY READ THE FOREGOING RELEASE AND WAIVER AND KNOW THE CONTENTS THEREOF AND HAVE SIGNED THIS RELEASE AND WAIVER AS MY OWN FREE ACT.

I expressly agree that this Release and Waiver is intended to be as broad and as inclusive as permitted by the laws of the State of Florida, and that if any portion thereof is held invalid, it is agreed that the balance shall notwithstanding, continue in full force and effect.


Photo Video Audio Release and Waiver


I hereby confer on the City of Coral Springs the absolute, irrevocable right and permission to use my image, and/or my child's image, in City media that includes but is not limited to print, digital or video format, for the purposes of public information, historical documentation, and/or promotion of City events and activities. I give my consent freely, with the understanding that no remuneration of compensation will be forthcoming.

Additional Information


Please complete the following information to better assist us.

Thank You


Thank you for completing your online application for the Firefighter I & II program.

You will move to the class selection and then application payment screen. Your application fee is required to process your application. As a reminder, your application will not be reviewed and you will risk the class selling out if you do not make payment right away.



YOU HAVE NOW COMPLETED PAGE 1 OF 3. SELECT SUBMIT APPLICATION TO AUTOMATICALLY PROCEED TO PAGE 2 TO SELECT THE CLASS START DATE.

4180 NW 120th Avenue ♦ Coral Springs, Florida 33065