Application

*** The Application and Personal Information Page MUST be sent in by January 31st ***

* Please read all instructions below *

* Download / Save the two documents to your computer before filling them out. Using an online viewer may not allow you to fill out the information properly.

* These documents are in Adobe PDF and require Adobe Reader http://get.adobe.com/reader/ (free download). If these documents do not open properly, you may need to install Adobe Reader to view them correctly on your computer.

Please click to view the Application

Please click to view the Personal Information Page

INSTRUCTIONS ON WHERE TO SEND DOCUMENTS:

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Print then mail or fax:

If you are going to mail or fax these forms to us, please Print them out and follow the information below on where to send it in. The documents can either be filled out via computer, or use a blue or black ink pen.

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Save and email:

If you are going to email these forms to us, SAVE the pdf files with your First and Last name as the file name (ex. John Smith.pdf ).

Save the Application as: First name Last name Application.pdf

Save the Personal Information page as: First name Last name PIP.pdf

Then use your regular email client to attach these forms in a new email message. Please put your First and Last name in the subject line of the email.

*** If saving or emailing does not work, please default to printing the documents, filling them out with blue or black ink pen, and mailing or faxing it in to us. ***

Where to send in the forms:

Once these two forms are completed, please mail, fax or email them with valid Medical training certification copies to:

MAIL:

Deputy Andrew Brosi - Search and Rescue Coordinator

Office of Emergency Services

4985 Broder Blvd.

Dublin, CA 94568

FAX: (925) 803-7878 Attn: Deputy Andrew Brosi - Search and Rescue Coordinator

EMAIL: abrosi@acgov.org