CHECKLIST
BASIC LOCAL CERTIFICATION
Name:
Title:
Agency:
Email Address:
Last Four of SS:
XXX-XX-
FEMA SID#
Applicant Position: Appointed Coordinator Deputy Coordinator Staff
Course
Date
Completed
Certificate
Enclosed
1. County Program Orientation
2. Duties & Responsibilities
3. Initial Damage Reporting
4. IS - 100.b
Introduction to Incident Command System
5. IS - 200.b
ICS for Single Resources and Initial Action Incidents
6. IS - 230.d
Fundamentals of Emergency Management*
7. IS - 235.b
Emergency Planning Course*
8. IS - 240.b
Leadership and Influence Course*
9. IS - 700.a
National Incident Management System: An Introduction
10. IS - 775
EOC Management and Operations
11. IS - 800.b
National Response Framework: An Introduction
*FEMA Professional Development Series Course
Revised 04/06/2015
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:
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