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PEIFFA Course Registration Form
Please use this automated registration process to register for PEIFFA courses. It is simple and fast. Someone will get back to you via email or telephone with available seats and details.
Course Name:
Course Date:
Course Location
Your Fire Department:
Firefighter Name:
First
Last
Contact Email:
Contact Phone Number:
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Please indicate if you would like to send additional members if spots are available:
Yes 1 More
Yes 2 More
Yes 3 More
No Additional members
If YES include ...
Fire Department Admin Contact Name
Fire Department Admin Contact Phone Number
Fire Department Admin Contact Email
Do Not Fill This Out
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