CHECKLIST
ADVANCED LOCAL CERTIFICATION
Name:
Title:
Agency:
Email Address:
Last Four of SS:
XXX-XX-
FEMA SID#
Applicant Position: Appointed Coordinator Deputy Coordinator Staff
Course
Certificate
Enclosed
1. IS - 3 Radiological Emergency Management
2. IS - 5.a An Introduction to Hazardous Materials
3. IS - 241.b Decision Making and Problem Solving*
4. IS - 242.b Effective Communication*
5. IS - 244.b Developing and Managing Volunteers*
6. IS 271.a Anticipating Hazardous Weather and
Community Risk
7. IS - 547.a, Introduction to Continuity of Operations
8. IS - 702.a NIMS Public Information Systems or
G 289 Public Information Officer Awareness
9. G 191 ICS/EOC Interface Workshop
10. ICS 300 Intermediate ICS for Expanding Incidents
*FEMA Professional Development Series Course
Municipal/County Agency
Recommendation
PEMA Area Office Recommendation
Signature:
Signature:
Name, Title
(Print):
Name, Title
(Print):
Agency:
Area Office:
Date:
Date:
PEMA State Training Officer
Approved
Signature:
Denied
Name (Print):
Date:
Revised 04/06/2015
click to sign
signature
click to edit
click to sign
signature
click to edit
click to sign
signature
click to edit